Just for Her: Realizing you too are at risk
By Lyn Tonelli, MD
Cascade Valley Arlington Internal Medicine
Heart disease has long been recognized as a disease affecting many middle-aged men, however it is an equally concerning cause of death and disability in women. Yet women are often excluded from heart disease research, receive less aggressive care, and do not recover as well as men after having a heart attack.
Women, as well as their doctors have often overlooked their symptoms of heart disease. Several factors contribute to this:
- Women generally feel they are less at risk for a heart attack than men are. This faulty assumption often delays them from getting emergency care. It may also be one of the reasons they do not consider the importance of modifying habits that put them at risk.
- Symptoms of heart attack in women are not always the same as those typically seen in men.
- Instead of the classic chest pain or pressure during activity common in men, women are more likely to have chest pain during rest, sleep, or periods of emotional stress.
- In addition to chest pain during a heart attack, women are also more likely to have neck and shoulder pain, nausea, vomiting, fatigue, and difficulty breathing.
- If a man has chest pain while resting, but not while active, it is unlikely he is having a heart attack. On the contrary, women may very well be having a heart attack with the only symptom being chest pain while resting.
If you experience chest pain, with or without any of the other symptoms, your doctor should evaluate you.
Heart disease risk factors for women:
- Major risk factors:
- Being postmenopausal (either naturally occurring or surgically induced)
- Diabetes
- Peripheral vascular disease
- Moderate risk factors:
- Smoking
- High blood pressure
- Elevated cholesterol
- Minor risks factors:
- Over 65 years of age
- Obesity
- Family history of heart disease
- A sedentary life style
Risk Modification
If you have not had a heart attack, but have one or more of the risk factors above, you should modify those risk factors within your control or begin prevention measures. You can work with your doctor to identify your risk factors and reduce your risk of heart disease.
While it is not possible to reverse menopause, aging, or change your family history, all other risks can be reduced.
- If you are diabetic, you need to work with your physician to keep your blood sugar in balance. Diabetes is an even stronger risk factor of heart disease in women than in men.
- Likewise, high blood pressure, especially if you have diabetes, should be treated aggressively.
- Your risk of heart disease if you are a heavy smoker is two to four times higher than if you do not smoke. Even if you are a light smoker (one to four cigarettes a day,) you still double your risk of dying from heart disease.
- Cholesterol is a risk factor for heart disease in women as well as men. High LDL (the bad cholesterol) is an important predictor of heart disease in men. However having a low HDL (the good cholesterol) is a more important predictor of heart disease in women.
- The most significant changes you as a woman can make to your overall health are to exercise regularly and maintain a normal body weight. Weight loss, if you are overweight, reduces your risk of developing diabetes. It also reduces your risk of high blood pressure, raises good cholesterol, and lowers your risk of a heart attack by 35%.
Heart disease kills more American women than any other health problem. There is new information on differences between men and women in the symptoms, diagnosis, and management of heart disease. It is important you, as well as your doctor, use this new information to improve early detection and management of heart disease. If you have risk factors for heart disease, you should talk with your doctor about risk reduction.
Disclaimer: This information is provided for educational purposes only. It should not replace a visit with your health care professional. Call your doctor if you need more information or have additional questions.