Women and Heart Disease

Heart disease is the leading cause of death in America, and - what may be surprising to many - more women than men die from it each year. About 44 percent of all deaths among American women can be attributed to some form of cardiovascular disease, and one out of every three women affected by heart disease is aged 40 or under.

"Many women don't exhibit the traditional symptoms of heart disease," says Dr. Susan Wilansky, a Texas Heart Institute at St. Luke's Episcopal Hospital cardiologist. "Some experience just shortness of breath, extreme fatigue upon exertion, or pain in the jaw or elbow. Women who suspect they are experiencing symptoms of heart disease should be sure to take them seriously, especially if they recur or persist for more than a few minutes."

It is important to be aware of those traits or behaviors - commonly known as "risk factors" - that can increase a woman's chances of developing heart problems.

"There is higher prevalence of heart-related illness in post-menopausal women," says Dr. Wilansky, "but pre-menopausal women who smoke, take oral contraceptives past the age of 40, have diabetes, hypertension or any other risk factors, have an increased susceptibility to cardiovascular disease as well."

While you can't control all of these risk factors, you can change or even eliminate some of them by making healthy decisions and lifestyle changes.

Coronary Heart Disease Risk Factors That You Can Control

Smoking is the single greatest preventable cause of death in the U.S. If you smoke a pack of cigarettes a day, your heart attack risk is about twice that of a non-smoker. But no matter how long or how much you have smoked, you can immediately reduce your heart attack risk by quitting.

High blood pressure (hypertension), if not treated, makes your heart work harder, accelerates atherosclerosis (hardening of the arteries), and increases your risk of heart attack, stroke, and kidney failure. Pregnancy may trigger high blood pressure, especially during the third trimester, but pregnancy-induced hypertension generally disappears after childbirth. Women who have a family history of hypertension (especially African-American women), are overweight, or have reached menopause also have an increased risk of developing high blood pressure. While hypertension can't be cured, it can be controlled with diet, exercise and, if necessary, appropriate medication. High blood pressure usually has no symptoms, so it is important to have your doctor regularly check your blood pressure.

High blood cholesterol: Cholesterol is a fat-like substance in the blood that contributes to atherosclerosis. There are two major types of cholesterol: high-density lipoprotein (HDL), and low-density lipoprotein, (LDL). HDL is called "good" cholesterol because it actually protects against coronary artery disease, while LDL is called "bad" cholesterol because it has been associated with a high risk for coronary artery disease. Cholesterol levels can be controlled by eating a low-fat diet, getting regular exercise, and in some cases, taking medication.

Obesity is a strong predictor of heart disease, especially among women. Some research has found that the distribution of fat is also an important predictor of heart disease risk and that women whose weight tends to accumulate around the waist are at greater risk than women whose weight accumulates around the hips. Beware of fad diets or programs that guarantee rapid weight loss. Healthy weight loss is gradual and is accomplished by improving eating habits and increasing physical activity. Ask your doctor or dietitian for help in setting up a weight loss program to help you safely and effectively lose weight.

Diabetes mellitus is a significant heart disease risk factor for all women, especially African Americans and Hispanics. Your cardiovascular risk is even higher if you have both diabetes and hypertension. If untreated, diabetes also can lead to numerous other health problems. Diabetes always requires the care of a doctor, and if you have diabetes, you should follow your doctor's instructions.

Physical inactivity increases the probability of developing heart disease. Regular physical activity helps keep your heart strong, maintains good circulation, controls blood pressure and cholesterol levels, and decreases mental stress. Many people can benefit from physical activity at least 30 minutes a day, three times a week. The activities can even include moderate-intensity pastimes such as gardening, yard work, walking, and housework.

Oral contraceptives may increase the risk of cardiovascular problems in women, especially those with other risks such as smoking and hypertension. The risks associated with oral contraceptives increase as women get older. Before you begin taking oral contraceptives, discuss any other cardiovascular risk factors that you may have with your doctor.

Stress can contribute to heart disease and can also lead to other risk factors, such as smoking and overeating. To control stress, try to identify situations that upset you or make you angry. Then work to find positive ways to relieve your stress, such as exercising.

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©2006 Texas Medical Center

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