Medicine Made Better®

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Heart Disease and Women

Cardiovascular disease is the No. 1 killer of women — who knew? Women are often so busy looking for signs of women’s diseases like osteoporosis or breast cancer they dismiss symptoms of heart disease because it’s a man’s disease. And yet more women die each year of cardiovascular disease than all cancers combined.

Heart attack symptoms in women

  • Pain in one or both arms, the back, neck, jaw or stomach
  • Shortness of breath
  • Cold sweat, nausea or lightheadedness
  • Extreme fatigue
  • Chest discomfort, pressure, squeezing or fullness that lasts more than a few minutes or that comes and goes

Take these signals seriously; call 911 immediately. The earlier treatment begins the higher the chance for survival.

Many women also ignore symptoms of cardiovascular disease because unlike the classic severe chest pain men often describe, studies show that women’s symptoms tend to be more nonspecific — fatigue, nausea and shortness of breath. And these symptoms are easy to brush off.

The risk factors for women include:

  • High blood pressure
  • High total and LDL cholesterol
  • Low HDL cholesterol
  • Diabetes
  • Smoking
  • Being overweight
  • Being physically inactive
  • Age (55 and older)
  • Family history

Staying healthy

The good news is that 80 percent of cardiovascular disease can be prevented. Annabelle Volgman, MD, medical director of the Rush Heart Center for Women suggests a heart-healthy diet and regular exercise to help maintain a healthy weight and avoid diabetes. If you smoke, quit. And if your blood pressure and cholesterol can’t be controlled through diet and exercise alone, medications can help. Prevention is important because more women than men die within the first year after a heart attack.

One reason for the higher death rate is that cardiovascular disease tends to begin later in women — after menopause. “Hormone replacement therapy (HRT) was thought to offer protection,” says Volgman, “but we now know that HRT actually increases the risk for stroke and heart attacks — and it increases the risk for breast cancer.”

Equal treatment?

Women may suffer higher death rates, too, because cardiovascular disease is often undertreated in women. “Normally every patient who has a heart attack or stroke should be on four medications: aspirin, beta blockers, and statins and ACE inhibitors. We’re finding that women are often missing at least one,” says Volgman.

When to seek help

If you have two or more risk factors or already have a cardiovascular problem, Volgman suggests you ask your primary doctor for evaluation by a cardiologist. “I tell patients who have several risk factors that they need to know their own bodies and how they feel when there’s nothing wrong. If there is a change — unexplained extreme fatigue — it may be a sign that there is something wrong and they should seek medical help.”

Call 911 if there is sudden chest discomfort or extreme fatigue that lasts more than a few minutes.

At the Rush Heart Center for Women, a nurse practitioner, general cardiologist, preventive cardiologist, endocrinologist, and nutritionists help patients understand their risks and how to control them.