Heart Disease: Why It's Different for Women

  -- By Karen Gardner, Health & Parenting Writer

Heart disease is not a disease that only affects men. According to the American Heart Association (AHA), heart disease kills more than 500,000 women annually. In 2001, well over half of the people who died from heart disease were women.

Yet, "Women still think they cannot have coronary disease," says Dr. Massimo Guisti of Cardiovascular Associates of Virginia, PC. "They are more afraid of ovarian or breast cancer, but coronary disease is the actually the leading cause of death in women."

Heart disease often presents itself differently in women than it does in men. That includes the warning signs of a heart attack as well. In addition to the classic heart attack warning signs, such as chest discomfort, shortness of breath and pain in one or both arms, women may experience these less common signs:

• Atypical chest, stomach or abdominal pain.
• Nausea or dizziness without chest pain.
• Shortness of breath and difficulty breathing without chest pain.
• Unexplained anxiety, weakness or fatigue.
• Palpitations, cold sweat or paleness.

The National Heart, Lung & Blood Institute reports that one in 10 American women, ages 45-64, has some form of heart disease. In women over the age of 65, these numbers double. For women, like men, the major risk factors for heart disease include increasing age, heredity, tobacco use, diabetes, high cholesterol, high blood pressure, physical inactivity and obesity.

While some of these factors, such as age and family history, cannot be modified, there are plenty others that can. The first step a woman can do towards reducing her risk of coronary disease is to take more responsibility for her health. Women must insist on a thorough risk assessment from their healthcare provider, and not be afraid to ask questions.

The American Heart Association suggests that every woman ask her healthcare provider these 10 questions about cardiovascular disease:

• What are my risk factors for heart disease?
• Am I at risk for a stroke?
• What are the warning signs of heart disease and a stroke?
• What should I know about the effects of menopause on my heart health?
• Do I need to lose or gain weight for my health?
• What is a healthful eating plan for me?
• What kind of physical activity is right for me?
• What is my blood pressure, and is it appropriate for my age?
• What is my cholesterol level, and is it healthy or does it need improving?
• Based on my history and risk factors, what can I do to lower my risk of heart disease and stroke?

For mature women, the question of menopause and heart health is particularly important. Long gone is the misconception that estrogen protects post-menopausal women from heart disease. Therefore, mature women need to maintain an open dialog with their primary care physician and gynecologist on the subject, and again do not be afraid to ask questions.

"Women are underrepresented in terms of the workup we do in the cardiac world," says Henrico Doctor’s Hospital cardiologist Dr. Gary Zeevi. "After menopause all women should have a fairly extensive evaluation of their coronary risk."

For more information on women and heart disease, visit the American Heart Association's Website.