Heart disease and women

Information

Mention the term "heart attack" and most people imagine a pudgy, middle-aged man drenched in sweat and clutching his chest. Few people seem to consider heart disease a woman's disease.

Yet cardiovascular disease is the leading killer of women over age 25. It kills nearly twice as many women in the United States as all types of cancer, including breast cancer.

Men have a greater risk for coronary artery disease and heart attacks earlier in life than women. Women's risk for heart disease increases after menopause.

EARLY HEART SIGNS

Women may have warning signs that they ignore for weeks, months, and even years before having a heart attack. Some doctors still do not recognize the warning signs reported by female patients.

ACT IN TIME

Recognizing and treating a heart attack right away improves your chance for survival. The typical American -- male or female -- waits 2 hours before calling for help.

Know the warning signs and always call 911 within 5 minutes of when symptoms begin. By acting quickly, you can limit damage to your heart.

MANAGE YOUR RISK FACTORS

A risk factor is something that increases your chance of getting a disease or having a certain health condition. You can change some risk factors for heart disease. Other risk factors you cannot change.

Women should work with their health care provider to address risk factors they can change.

Estrogen is no longer used to prevent heart disease in women of any age. Estrogen may increase the risk of heart disease in older women. However, it may still be used in some women to treat hot flashes or other medical problems.

For some women who are at increased risk for heart disease, daily low-dose aspirin may be used to prevent heart attacks. Because aspirin can increase the risk for bleeding, your health care provider should discuss whether the benefits outweigh the risks in your case.

LIVE A HEALTHY LIFESTYLE

Some of the risk factors for heart disease that you CAN change are:

If you drink alcohol, limit yourself to no more than one drink per day.

Good nutrition is important to your heart health, and it will help control some of your heart disease risk factors.

References

Gaziano JM, ridker PM, Libby P. Primary and secondary prevention of coronary heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular MEdicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 49.

Hansson GK, Hamsten A. Atherosclerosis, thrombosis, and vascular biology. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 70.

Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: A guideline from the American Heart Association. Circulation. 2011;123(11):1243-1262.

Newby LK, Douglas PS. Cardiovascular disease in women. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular MEdicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 81.

North American Menopause Society. Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010;17:242-255.

Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;150(6):405-410.

Goldstein LB, Adams R, Alberts MJ, et al; American Heart Association; American Stroke Association Stroke Council. Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2006;113(24):e873-923.