Heart Disease: Advice Just for Women

You might be surprised to know that heart disease is the leading cause of death among women, taking more lives each year than the next six leading causes of death combined, including cancer.

If you’re a woman over age 45, it is especially important to know the warning signs of a heart attack. The signs and symptoms are not quite the same for women as they are for men. Many women are also unaware that in many cases, heart disease can be prevented or controlled.

Studies that have shown that physicians don’t tend to be as aggressive when it comes to screening women for heart disease, notes cardiologist Marc Tecce, MD, of the Jefferson Heart Institute at Thomas Jefferson University Hospital. This is due in part to the fact that the peak onset of heart disease in women doesn’t occur until the ages of 60 to 65, after they have undergone menopause, and 10 years after the peak period for men, which is from ages 50 to 55.

“Also, women have traditionally perceived other diseases, particularly breast cancer, as a greater health risk to them,” Dr. Tecce adds.

As for those differences in signs and symptoms, he explains, “Women may not get the chest pain that men get; in fact, it’s not uncommon that they don’t have chest pain.

“If women do experience chest pain, it may not be related to exertion,” Dr. Tecce continues. Whereas men’s chest pain is typically related to exertion or activity, women get chest pain while at rest.

“But more commonly, women’s heart disease warning signs may be in the form of stomach reflux or esophageal pain, or simply shortness of breath or fatigue from activities and exercises they could easily perform before.”

Women shouldn’t automatically assume they are having a heart attack whenever they feel fatigued, Dr. Tecce cautions. But they absolutely should see their doctor to be on the safe side.

Despite the differences in warning signs and symptoms, Dr. Tecce adds, women face the same risk factors for heart disease as men – i.e., smoking, diabetes (causing high blood glucose), high blood pressure, high cholesterol and a family history of heart disease.

Jack Garden, MD, another Jefferson Hospital cardiologist and Chief of Cardiology at Jefferson’s Methodist Hospital Division, and Instructor of Cardiology at Jefferson Medical College of Thomas Jefferson University, says there are many things women can do to lower their risk of heart disease and heart attack. “Healthy lifestyle choices can help prevent or control heart disease,” Dr. Garden says. “We want women to ask for help if they need support to make changes or don’t know where to begin.”

Dr. Garden says that maintaining a healthy weight, eating a low-fat and low-salt diet, exercising, and quitting smoking are all steps women can take to prevent or control heart disease. He recommends avoiding popular fad diets, reminding patients that weight loss should be slow and steady. This helps you adjust to healthier lifestyle choices that can be maintained long-term.

While Dr. Tecce agrees that weight loss should be slow and steady, he is not opposed to certain reasonably good fad diets, such as the South Beach Diet, for morbidly obese patients whose need to lose weight is particularly urgent.

If you have to take medication to control heart disease, Dr. Garden says that it’s important for you to follow your doctor’s advice. Patients need to be sure that they know how and when to take their medication, and to take the medication exactly as prescribed.

Knowing and understanding your cholesterol level is also important, Dr. Garden says. Starting at age 45, women have higher cholesterol levels than men. That may be because the protective benefits of estrogen start to lessen as women enter menopause. Elevated cholesterol levels are one major risk factor for heart disease.

Adds Dr. Tecce, diabetics should be sure to monitor their glucose levels regularly.

“Unfortunately, heart attack and stroke in women are often fatal the first time, so prevention is extremely important,” Dr. Garden says. “Women need to be informed about their health to make choices that can improve the quality of, and extend, their lives.”

According to the American Heart Association, if you are over 65, you can take advantage of free screenings available through Medicare to check your cholesterol, lipid levels and triglycerides. The screening is free of charge every five years. Thomas Jefferson University Hospitals, including our Methodist Hospital Division, encourage patients to discuss this option with their primary care physicians.