Women & Heart Disease

There was a time when coronary heart disease (CHD) was believed to mostly affect men and doctors rarely looked for signs and symptoms in women. The reality is that CHD is the leading cause of death for both men and women in the United States and in most developed countries around the world. However, over the past 40 years there has been a major reduction in CHD deaths of men in the US. The same has not been true for women. For the past 25 years more women than men die of CHD every year.

There are many reasons why detecting and treating CHD in women has been difficult:

• Women have more “atypical” symptoms of CHD compared to men
• Women have more silent ischemia — meaning blood flow to the heart is restricted but there is no chest pain
• Even when women report symptoms, they show less obstructive CHD compared to men with the same degree of symptoms, suggesting a disease pattern that is different than men
• Once women develop obstructive CHD, they appear to have more adverse outcomes compared to men — including a greater risk of dying

Basic Facts About Women and Heart Disease

• One in four women dies from CHD, making it the #1 killer of women, regardless of race or ethnicity
• While more women today understand that CHD is the leading killer of both men and women, most women fail to make the connection between risk factors and their personal risk of developing CHD
• More women (52%) than men (42%) die from a heart attack before reaching the hospital
• Two-thirds of women who suffer a heart attack never fully recover
• One in three adult females has some form of cardiovascular disease
• Women who are obese, physically inactive, older than 65, of certain ethnicities, have high blood pressure or high cholesterol levels, have a greater risk of developing CHD, as do women with diabetes or pre-diabetes
• Numerous medical tests can help determine whether a person has CHD, but the effectiveness of individual tests varies by sex of the participant
• The relationship of birth control and hormone therapy to CHD is not fully understood and should be discussed with your physician

Signs in Both Women and Men

• Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest that lasts more than a few minutes or goes away and comes back
• Pain that spreads to shoulders, neck or arms
• Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath

Common Signs of Heart Attack in Women

• Stomach or abdominal pain or unusual chest pain
• Nausea, dizziness, or a feeling of heartburn (acid indigestion)
• Shortness of breath and difficulty breathing
• Unexplained anxiety, weakness, or fatigue
• Palpitations, cold sweat, or paleness

Questions Every Woman Should Ask Her Doctor

It is not uncommon for a woman to be completely unaware that she is at risk for heart disease. It is critical to discuss your risk with your primary care physician. Below are some questions to guide the conversation:

• What screening or diagnostic tests for heart disease do I need?
• What are my test numbers and what do they mean?
  • Blood pressure
  • Cholesterol (total cholesterol, LDL, HDL and triglycerides)
  • Body mass index
  • Blood sugar level (risk for diabetes)
• How can I get help with smoking cessation?
• How much physical activity do I need to help protect my heart?
• What is a heart-healthy eating plan for me?
• What are the warning signs of heart attack or heart disease?
• If I experience heart attack symptoms, what should I do?