DOCTOR'S VIEW ARCHIVE

Heart Disease in Women

Medical Author: Carolyn J. Crandall, MD, FACP
Medical Editors: Dennis Lee, M.D., Jay W. Marks, M.D., Daniel Lee Kulick, M.D.

What is the Risk of heart attacks in women?

Coronary artery disease (CAD) and heart attacks are erroneously believed to occur primarily in men. Although it is true that the prevalence of CAD among women is lower before menopause, the risk of CAD rises in women after menopause. At age 75, a woman's risk for CAD is equal to that of a man's. CAD is the leading cause of death and disability in women after menopause. In fact, a 50-year-old woman faces a 46% risk of developing CAD and a 31% risk of dying from coronary artery disease. In contrast, her probability of contracting and dying from breast cancer is 10% and 3%, respectively.

The risk factors for developing CAD in women are the same as in men; they are increased blood cholesterol, high blood pressure, smoking cigarettes, diabetes mellitus, and a family history of coronary heart disease at a young age.

Smoking cigarettes

Even "light" smoking raises the risk of CAD. In one study, middle-aged women who smoked 1 to 14 cigarettes per day had a twofold increase in strokes (caused by atherosclerosis of the arteries to the brain) whereas those who smoked more than 25 cigarettes per day had a risk of stroke 3.7 fold higher than that of nonsmoking women. Furthermore, the combination of smoking and the use of birth control pills increase the risk of heart attacks even further, especially in women over 35.
Quitting smoking immediately begins to reduce the risk of heart attacks. The risk gradually decreases back down to the same risk of nonsmoking women after several years of not smoking.