Heart disease in women

When it comes to heart disease misperceptions abound and partly explain the high death rate of heart disease in women — and particularly in younger women. Based on results from several studies, the majority of women are not aware of their risk of heart disease. Nor do most women recognize the symptoms of a heart attack. That mistake can prove to be deadly. Heart disease is the number one killer in both men and women.

Yet, if you ask women to name the biggest killer among women, many would answer “breast cancer.”

Indeed breast cancer is the most common cancer in women and trails only lung cancer in the number of cancer deaths, but its numbers pale in comparison to heart disease. While roughly 40,000 women die of breast cancer each year, almost 300,000 women succumb to heart disease each year, according to the Centers for Disease Control and Prevention.

A recent study commissioned by the American Heart Association revealed that much work needs to be done to increase awareness of heart disease, particularly in women of color. Only one third of African American and Hispanic women interviewed were aware of heart disease’s deadly impact.

This lack of awareness among women was the driving force behind the American Heart Association’s “Go Red for Women” campaign.

“Heart disease” is somewhat of a catchall term that includes a number of different heart ailments, including heart failure, arrhythmias (irregular heartbeats) and coronary artery disease, for example. Coronary artery disease, which results from a buildup of plaque in the arteries, is the most common type of heart disease and the cause of angina and heart attacks.

Awareness of signs of a heart attack is equally wanting. Although chest pain is generally well recognized, some women instead experience pain in the arm, back or jaw. Some have shortness of breath, nausea and cold sweats. Excessive fatigue is more common in women than in men. If you experience these symptoms, call 911.

The event of the heart attack is bad enough. Worse are the consequences that continue for several years in women. The National Heart, Lung and Blood Institute, a component of the National Institutes of Health, found that 23 percent of women die within the first year of a heart attack, and almost half become disabled with heart failure within six years of an attack.

Adding to the problem is that treatment for heart disease can be more challenging in women. Often the small arteries of the heart are afflicted (microvascular disease) which prevents standard remedies, such as bypass surgery or angioplasty.

In spite of its prevalence and dire consequences, heart disease is largely preventable. According to a case-control study involving 52 countries (INTERHEART), control of nine easily measured and potentially modifiable risk factors could result in a 90 percent reduction in the risk of an initial heart attack. The research further concluded that this reduction was consistent in men and women and different ethnic groups.

Some risk factors, such as age, family history and race cannot be modified, while other risk factors can be prevented or controlled if diagnosed. High blood pressure and cholesterol, obesity, unhealthy diet, inactivity, diabetes and smoking are all correlated to heart disease. Even stress and emotion are considered heart risks.

Having one risk factor doubles the risk; having more increases the risk exponentially, according to health experts. A snapshot of risk factors in women indicates the gravity of the situation, especially among African Americans. Black women are more likely to have high blood pressure and diabetes and engage in very little physical activity. More than 80 percent are overweight or obese due largely to an unhealthy diet. These factors explain in large part why the incidence of heart disease in black women is second only to that in black males.

The AHA is offering women the opportunity to participate in a study to learn why some women are more at risk for heart disease than others. The online study consists of health-related questions, which can be answered in one setting or in increments of five minutes or more. The Heath eHeart Study is available at https://www.health-eheartstudy.org.