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Caring for her heart Heart disease is the No. 1 killer of women

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Fundador Adajar, MD

When most of us think of a heart attack victim, chances are, we picture a man. However, a woman’s risk of having a heart attack is higher than a man’s. In fact, heart attacks are the leading cause of death among women. About 1 in 4 women die of heart disease.

American Heart Association

Cardiovascular disease is the No. 1 killer of women over age 40, and the risk rises with age. Despite this evidence, just 34 percent of women in a 2000 National American Heart Association survey correctly named heart disease as a leading cause of death — and only 8 percent could identify it as their No. 1 health threat.

Traditionally, men have gotten the bad rap for their reluctance to visit the doctor and continue to hold the stereotype of the negligent male patient while the more health-conscious wife, daughter or girlfriend insists on getting help when needed. However, the rate of heart disease and related risk factors are actually increasing in women, and decreasing in men. There are many reasons for this disparity.

Atypical symptoms

Heart attack symptoms for women can be different than those that typically occur for men and often, women dismiss these symptoms as being a sign of stress, a panic attack or fatigue. However, keep in mind that men can have these same atypical symptoms. (See inset box.)

Biological factors

Certain biological factors that only affect women carry a certain degree of heart disease risk.

Health occurrences during a woman’s pregnancy — once thought to have no significant bearing on her long-term health — now have been determined to be contributing risk factors for heart problems. A woman who develops preeclampsia (pregnancy-induced hypertension), gestational diabetes, or high blood pressure during pregnancy increases her risk for glucose intolerance, obesity, diabetes and hypertension later in life — which are all risk factors for heart disease. In fact, according to the National Heart, Lung & Blood Institute, 80 percent of women, ages 40 to 60, have at least one risk factor for heart disease.

Menopause is also thought to contribute to elevated heart disease risk, because in addition to the drop in estrogen production, post-menopausal women also experience changes in the walls of the blood vessels (making it easier for plaque and blood clots to form). It also causes a drop in HDL (good) cholesterol and an increase in LDL (bad) cholesterol, and an increase in the level of fibrinogen in the blood, a substance that makes it easier for the blood to clot. However, replacing estrogen in post-menopausal women (i.e. taking Premarin) has not been shown to reduce your chances of having a heart attack or stroke.

Some heart conditions affect only women due to the structure of a woman’s heart. It has been shown that women have a more difficult recovery after a heart attack. Recent studies have shown that a type of heart disease known as coronary microvascular disease (MVD) — which affects the heart’s smallest arteries — is more common in women. And, standard tests for coronary heart disease don’t always detect MVD in women, according to the National Heart, Lung & Blood Institute. Thus, women once thought to be at lower risk for heart disease may have actually gone undiagnosed.

Finally, women are more likely than men to suffer depression following a heart attack, and are less successful at adopting new — and healthier — lifestyle habits. Therefore, their risk of a repeat heart attack is higher.

It is important for women to be aware of their risk of heart disease and start early in age to prevent a heart attack or stroke. The “Little Red Dress” is a national symbol for women’s heart disease, which brings awareness to others that it is the No. 1 killer of women. Talk to your doctor to find out your risks and how you can prevent you, your mother, your daughter, sister, aunt and grandmother from having a heart attack or stroke.

Fundador Adajar is a medical doctor with Eastern New Mexico Medical Group — Cardiovascular Specialists. The advice offered in this column is that of the author.