Heart Health Fundamentals

Heart disease is the leading cause of death among women. We spend a lot of time worrying about breast cancer, which is obviously a valid concern, but heart disease kills six times as many women each year. In fact, more women die from cardiovascular disease than all forms of cancer.

Amazingly, women aren’t the only ones who don’t seem to realize the risks. A national survey conducted late in 2004 found that less than one in five physicians knew that more women than men die each year from cardiovascular disease.

Too many people think that a heart attack takes place just like what we’ve seen on TV or the movies. Someone grips their chest in pain and falls to the floor. Granted, chest pain is the most common symptom of a heart attack, but not everyone having a heart attack has this particular symptom. Women are less likely than men to feel chest pain during a heart attack. Women are more likely to experience what are called atypical symptoms. These may include back pain, nausea, fatigue or jaw pain which women are more likely to experience than any other symptom.

Women experiencing a heart attack often wait a couple of hours or more after their symptoms occur to seek medical attention. Clinical studies have shown that women are often “too busy organizing” or “dressing up” before going to the emergency room, and this delay–no matter how brief–in getting medical treatment can be deadly. Many of the lifesaving treatments for heart attacks work best when given to patients within the first hour.

Most of us know that chest pain, shortness of breath, sweating, and pain in both arms can signal a heart attack. But just what are some of the most common, atypical heart attack symptoms?

• Back, neck, or jaw pain
• Nausea
• Vomiting
• Indigestion
• Weakness
• Fatigue
• Dizziness
• Lightheadedness

Women should not only be looking at atypical symptoms, they should also be aware of pre–heart attack (or prodromal) symptoms that may begin occurring as much as four to six months before an actual heart attack. These include:

• Unusual fatigue
• Sleep disturbance
• Shortness of breath
• Chest pain
• Indigestion
• Anxiety
• Pain in shoulder blade or upper back

In addition to simply being born female, ethnic and socio–economic issues also play a key role in heart health. African–American women between the ages of 55 and 64 are twice as likely as Caucasian women to have a heart attack, and 35% more likely to suffer from coronary artery disease. As with so many diseases we are discussing, smoking, lack of physical activity, and obesity all play a major role in the development of heart disease.

Until very recently large federally funded studies aimed at determining risk factors for heart disease did not include women. Government reports as recently as the early 1990’s noted that women were not included in studies demonstrating the safety and efficacy of therapies for cardiovascular disease. What this means is that it’s only been in the last few years that we have been able to begin understanding the differences between women and men when it comes to everything from heart attacks and strokes, to what constitutes a healthy cholesterol level for a woman. Gathering this information (and we are still a long way from having as much data as is available for men) is assisting health care providers in determining what medications and doses will work best for women, how symptoms differ, what treatment options should be considered, and how lifestyle changes can help.

Unlike many serious health issues that are unavoidable, we can often prevent serious heart problems by better understanding heart and cardiovascular disease, and taking the necessary preventive measures whenever possible. It’s important to educate ourselves and our health care providers so that we can actively work at preventing this disease. Eating the right foods, getting enough sleep, and making sure to keep moving our bodies, whether it’s a daily walk or time in the gym, are all proactive ways to maintain our heart health.

Even our mental health can play an important role in the development of heart disease.

• Women who are depressed, with no history of heart or blood vessel problems, are at a much greater risk of dying from heart disease
• Poverty increases the risk of heart attack and death in heart disease patients and otherwise healthy people
• Hostility may double a woman’s risk of having a heart attack
• Women in high–powered jobs have an increased risk of heart disease compared with women who have little control over their work – the opposite is true of men
• Caring for a spouse increases a woman’s risk of developing and dying from heart disease. This is especially true if she is unhappy as a caregiver
• Marital stress may increase the risk of a second heart attack or chest pain in women with heart diease