Many of the half million women who will be stricken by a heart attack this year will be caught by surprise. Although public awareness that women are vulnerable to heart disease, heart attack victims, are by stereotype, men. Since coronary heart disease is the number one killer of women in this country. I think every woman should know the facts about heart attacks.
SymptomsOne of the reasons that heart disease is under-diagnosed and under-treated in women is because typically, we experience heart attacks differently then men. Rather than the classic crushing pain in the chest and numbness down the left arm that most people associate with a heart attack, women often experience pain in the upper abdomen, lower back or below the chest. They may feel nauseated, short of breath or experience unusual fatigue for days or even weeks leading up to an attack. Warning signs can be intermittent and often intensify during physical exertion. Women are more likely to delay seeking treatment than men because they don't connect what the symptoms they are experiencing to a problem with their heart.
Risk Factors
Many of the risk factors for coronary heart disease - a family history, high blood pressure, high cholesterol, smoking, excess weight, a sedentary lifestyle, and diabetes - are the same for women as men. These risks are particularly potent for women because their hearts and arteries are smaller. Women also tend to exhibit more individual risk factors than men. For instance, a greater percentage of females smoke or have diabetes. More women, especially minority women, have high blood pressure. And, there are more women who are overweight. Oral contraceptives may also increase a woman's risk of heart disease. For example, women over the age of 35 who have high blood pressure or who smoke and take oral contraceptives up their chances of having a heart attack or a stroke. In some women, oral contraceptives may spike cholesterol levels which, in turn, can cause damage to the cardiovascular system.
Risk CategoriesIn 2004, The American Heart Association released its first heart attack risk categories for women. High risk women run a greater than 20 percent chance of having a heart attack in the next ten years; this includes women with diagnosed heart disease, a history of heart troubles or who have type 2 diabetes. Women in the moderate risk category - those with at least one risk factor or a propensity for poor health habits (poor diet and sedentary lifestyle) - have a 10-20 percent chance of suffering a heart attack in the next decade. Low-risk women display no risk factors and enjoy healthy lifestyles Their chances of experiencing a heart attack in the foreseeable future are relatively slim.After MenopauseData from the Women's Health Initiative hormone replacement therapy trial, which followed 16,000 healthy post-menopausal women for more than five years, determined that diminished estrogen levels do not appear to be responsible for the sharp increase in heart disease observed after a woman reaches menopause; nor does hormone replacement therapy seem to offer any heart protective benefits. Some experts speculate that perhaps the loss of iron during menstruation could be the reason younger women aren't as susceptible to heart disease as younger men or postmenopausal women. Lower iron levels in the blood may help limit damage to arteries by preventing the formation of artery clogging plaque. Though studies thus far are mixed on this theory, men who give blood (and so, mirror the iron-loss patterns of menstruating women) also have a lower incidence of heart disease. Whatever the reasons, by the time a woman reaches her golden years, all heart-health advantages disappear. Women in their seventies have an equal incidence of heart disease as do their male counterparts. Laura Corio, M.D, is the author of The Change Before the Change. For more information, please visit Dr.Corio's website.
