Strong Hearts, Strong Women
Five times more women die from heart disease than breast cancer—one almost every minute.
Heart disease is the number one cause of death for both men and women. But it affects women in different ways.
For example, the "Hollywood Heart Attack Myth" lends drama to the movies when a person staggering and clutching his chest appears to have a heart attack. But in real life, that is not exactly what happens—especially for women. Women experience “atypical” symptoms: unexplained fatigue, shortness of breath, nausea, trouble speaking, severe headache, and pain and numbness in face, arms, legs or back.
Ian Cohen, MD, new Medical Director of Cardiology at Northwestern Lake Forest Hospital, answers your questions about women and heart disease below.
Q: Heart disease is perceived as “a man’s disease,” or something that happens to older women. What are the facts?
A: Since the mid-1980s, more women than men have died from heart disease each year. And because women are often older when they experience a heart attack, they are more likely than men to die within the first year or suffer long-term, debilitating effects. However, heart disease threatens all women, even those as young as 30 or 40. The number of younger or middle aged women experiencing heart attacks is on the rise.
Furthermore, nearly 80 percent of women experiencing symptoms say they would “wait and see,” or call a friend or family member before calling an ambulance. But only an emergency technician can provide the stabilization and speed needed to save your life and limit the long-term damage to your heart muscle.
Q: What’s the connection between female hormones and heart disease?
A: The female hormones estrogen and progesterone provide a layer of protection against heart disease, possibly slowing the accumulation of plaque in the arteries. So when a woman reaches menopause and natural hormone levels decline, her atherosclerotic profile changes, the blood vessels may lose elasticity, and her risk of heart disease increases. Controversy remains regarding the role of artificial replacement hormones. If you are concerned, talk to your gynecologist.
Q: Women are more likely than men to have a heart attack even if they have “normal” test results. Why?
A: Women tend to have less obstructive heart disease, where cholesterol clogs the artery over time. Instead, they may be more vulnerable to rapid development of plaque build-up on blood vessel walls—they are not experiencing a slow, progressive build-up. And keep in mind that to fail a stress test, you need at least 70 percent blockage in at least one artery, and most heart attacks occur in blood vessels with less blockage. In fact, many heart attacks occur in people whose narrowed arteries were not identified through standard tests.
Q: A study in the medical journal Heart showed treatment disparities between men and women following a heart disease diagnosis. What are your thoughts?
A: The medical community has historically undervalued women. The vast majority of cardiovascular research has been performed on men, and women are not always treated the same way or as aggressively. My advice is to find a good physician and speak up. A specialist you see regularly may be focused on your other health needs, so do not wait for the subject of your heart to come up. Ask what tests will help determine your personal risk.
Q: Can calcium or other supplements prevent heart disease?
A: Lots of studies have looked at supplements, but when put to a scientific test they haven’t panned out. In fact, there have been recent conflicting studies about the effect of calcium on a woman’s arteries. I believe a basic multivitamin with a fish oil supplement won’t harm you, but supplements will not have the effect that many people hope for. Good diet, exercise, regular physician visits and knowing your risk factors are the best prevention.
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