Heart Disease: What Women Should Know
Priya Kumaraguru, M.D.
Family Practice Physician
OSF Saint Anthony’s Physician Group
#2 Saint Anthony's Way, Alton
Heart disease is the number one killer of both men and women in this country. More than half of fatal heart attacks each year happen to women.
One reason for the popular stereotype is that, because of hormonal differences, heart disease tends to strike women after menopause, an average of 10 years later than it does men.
Women, Hearts and Their Risks
RISK FACTORS: While modifiable risk factors are generally the same for men and women, there are gender differences in the way these are expressed.
Smoking increases the relative risk for women by at least 25 percent compared to men, according to one recent study using pooled data from 2.4 million subjects. The study also found the longer a woman smokes the greater her risk compared to a man smoking for the same length of time.
While obesity affects both genders, being even a little overweight can dramatically increase a woman’s risk of a heart attack. A woman 5 foot 4 who weighs 140 pounds has a 30 percent higher risk than a woman the same height weighing 125 pounds.
And women under 5 feet tall have a 50 percent increased risk of a heart attack, regardless of weight. This may be due to smaller arteries.
Obese women have a nine-fold increased risk of diabetes, and diabetes increases a female’s risk of coronary heart disease three- to seven-fold compared to two to three-fold for a male.
Women tend to have higher HDL (good) cholesterol levels than men until menopause. But by age 60, their HDL levels start to drop, and their LDL levels tend to rise higher than the average males.
In addition, women tend to have higher levels of CRP (c-reactive protein), a marker of inflammation. And high CRP is a greater risk factor for women than for men. High triglycerides are also a more potent risk factor for women than for men.
After age 45, women have a higher prevalence of hypertension, especially African-American females.
SYMPTOMS: Angina (or chest pain) is the most recognized symptom of a heart attack, but chest pain in women often does not meet the typical definition. That may be because women are less likely than men to have the completely obstructed coronary arteries that cause the crushing chest pain.
Women are more likely to complain of neck and throat pain, and it may be intense, sharp or burning rather than crushing. Other signs may include shoulder pain, dizziness and fatigue over several hours or even days.
Many women experience early prodromal symptoms more than a month before a heart attack–unusual fatigue, sleep disturbance, shortness of breath, indigestion, anxiety and non-specific chest discomfort.
Underestimating the gender-related risk, many women, and even their doctors, fail to take note. And even when an angiogram is performed, the severity of the disease may not be apparent.
How can you protect yourself? The first step is to understand your risk – as a woman and as an individual. The next is to take action as early as possible: exercise, don’t smoke, control your weight and watch your blood pressure and cholesterol. Listen to your body for signs. And, make it a point to talk to your health care provider about your heart health.