Although heart disease is often thought of as “a man’s problem,” the reality is that all women are at risk. In a survey by the American Heart Association, women worry more about getting breast cancer, even though heart disease kills six times as many women every year.
Women of all ages must protect their heart health and understand the signs and symptoms of heart disease, learn the risk factors and take steps to prevent it.
“Coronary heart disease, also called coronary artery disease, occurs when plaque builds up on the inner walls of the coronary arteries,” says David Portugal, MD, medical director of the catheterization lab at Memorial Hermann Heart & Vascular Institute–Southwest. “The arteries are important because they carry oxygen-rich blood to the heart. Problems occur when the plaque hardens, causing the coronary arteries to narrow, thus reducing the flow of this oxygen-rich blood to the heart. The result may be chest pain or discomfort.”
Plaque is composed of fat, cholesterol, calcium and other substances found in the blood. If plaque ruptures, a blood clot can form on its surface. A large blood clot can block the blood flow through a coronary artery. This is the most common cause of heart attacks in both men and women.
These other types of heart disease pose a serious risk for women and are not as well known:
Coronary microvascular disease (MVD) is a heart disease that affects the heart’s tiny arteries. A drop in estrogen levels during menopause, combined with other heart disease risk factors, may be the cause.
Women with coronary MVD experience chest pain or discomfort often during simple daily activities such as shopping or cooking.
Broken Heart Syndrome is also referred to as stress-induced cardiomyopathy. The most common symptoms are chest pain and shortness of breath and the symptoms tend to occur suddenly in people who have no prior history of heart disease.
“Extreme emotional stress can lead to severe heart muscle failure,” explains Marco Campos, MD, a cardiologist affiliated with the Memorial Hermann Heart & Vascular Institute–Memorial City. “The symptoms and test results for broken heart syndrome are similar to a heart attack but the patient will show no evidence of blocked heart arteries. The good news is that most people have a full recovery.”
Peripheral arterial disease (PAD) of the legs is also called atherosclerosis. It occurs when the long arteries in the legs harden and narrow, limiting blood flow to muscles. The most common symptom is pain or nagging muscle aches in the legs.
“The body’s circulatory system is interconnected,” says Amilcar Avendano, MD, an interventional cardiologist affiliated with Memorial Hermann The Woodlands Medical Center. “Individuals with atherosclerosis of the legs commonly have atherosclerosis in other parts of the body, putting these patients at increased risk for heart attack or stroke.”
PAD and coronary heart disease are related; individuals who have one are likely to have the other.
“The symptoms may be vague and can easily go unnoticed by the patient,” cautions Ross Brown, MD, an interventional cardiologist affiliated with Memorial Hermann Heart & Vascular Institute–Memorial City. “In this case, we aren’t dealing with blockages in the arteries as in a typical heart attack.”
Symptoms in women may include:
Women and men alike may ignore heart attack symptoms because they mistakenly think that the discomfort will pass or that they would never have a heart attack. Some are even embarrassed, thinking, “What if it turns out to be nothing?” Don’t take the chance. If you or a family member experience these symptoms, or think it could be a heart attack, immediately call 9-1-1.
Risk factors are conditions or habits that make a person more likely to develop a disease and some cannot be controlled. According to the National Heart, Lung, and Blood Institute, having just one of these risk factors can double your chance of developing heart disease.
For women, age becomes a risk factor at 55. Until menopause, ovaries produce estrogen that protects women against plaque buildup. At menopause, ovaries stop making estrogen, increasing a woman’s risk. With age, arteries get stiffer and thicker.
Women with a father or brother who developed heart disease before age 55 are at higher risk. Women with a mother or sister who developed heart disease before age 65 are also at higher risk.
As a group, African-Americans are more likely to develop high blood pressure; racial and ethnic minorities are generally more likely to develop heart disease.
“The older a women gets, the more likely she is to get heart disease,” says Susan Laing, MD, director of echocardiography, affiliated with Larry D. Johnson Heart & Vascular Institute at Memorial Hermann-Texas Medical Center. “Although in general, women tend to develop heart disease about 10 years later than men, this does not hold true for women with diabetes or women with a significant family history of early heart disease. In these women, we see heart disease much earlier. Also, after menopause, women catch up with men with regards to the likelihood of getting heart disease.”
The good news is that there are lifestyle changes a woman can make at any age to reduce her risk of heart disease. Among the most important are following a heart-healthy diet low in saturated fat, cholesterol and salt and getting regular exercise almost daily.
While traditional risk factors, such as high blood pressure and obesity, apply to both men and women, some risk factors have a stronger impact in the development of heart disease in women:
Pregnancy complications can increase a woman’s long-term risk of high blood pressure and diabetes and can increase the risk of development of heart disease in both the mother and her children.
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