Feature Archive

Women and Heart Disease

By Michele Bloomquist
WebMD Feature

May 22, 2000 -- To protect yourself from having a heart attack, you need to reduce your risk factors and know the signs to watch for, says Nieca Goldberg, MD, a spokesperson for the American Heart Association (AHA). Because coronary heart disease is the leading killer of women in the United States, being a proactive patient may very well save your life.

The cholesterol-rich plaque that builds up on the walls of heart arteries -- and that leads to coronary heart disease and heart attacks -- starts to form in early childhood and builds over a lifetime. When blood can no longer squeeze through the plaque-narrowed artery or when high blood pressure causes the artery to burst, a heart attack occurs.

While you can change some risk factors for heart disease -- high blood pressure, poor diet, uncontrolled diabetes, and inactivity, for example -- there are others you can't, like genetics and age. The more risk factors you have -- if you're an overweight smoker with high blood pressure, for example -- the higher your chances of having a heart attack.

Don't be shy about starting the discussion about heart health with your doctor and asking for appropriate testing and treatment. "Preventing heart disease before it occurs or leads to a heart attack is the best solution," says Goldberg. Here are some prevention tips from the AHA:

  • Stop smoking: Lung cancer isn't the only hazard of cigarette smoking. Smokers are twice as likely to have a heart attack as nonsmokers, says the AHA. Many studies show that smoking is a major cause of coronary heart disease, which leads to heart attack. If you have trouble giving up smoking on your own, ask your doctor to recommend smoking cessation programs.
  • Reduce high cholesterol: Cholesterol is a soft, waxy fat found in the blood. Too much of it can lead to plaque buildup and heart attacks. Ask to have your cholesterol level tested starting at age 21 and every five years after that. If it's high (above 200), have it tested more often, and work with your doctor to reduce it with medication, dietary changes, and exercise.
  • Treat high blood pressure: Request a blood pressure screening every two years. If your blood pressure is high, get medication if needed and take it faithfully. High blood pressure is a serious condition that silently makes the heart work harder, weakening artery walls and encouraging plaque attachment.
  • Exercise regularly: Most women don't get nearly enough exercise to promote a healthy heart. How much do you need? The AHA recommends no fewer than three to four sessions per week, at least 30 minutes each. (Make sure to first check with your doctor to see if it's safe for you to work out).
  • Maintain a healthy weight: A body mass index (BMI) of between 21 and 25 is ideal, according to the AHA. (BMI equals a person's weight in kilograms divided by height in meters squared. A handy BMI chart can be found at: http://www.consumer.gov/weightloss/bmi.htm.)

    If your BMI is above 25, you may be at increased risk for heart disease, and you might want to stick to a sensible diet to bring your weight within the recommended range. If you have trouble losing weight on your own, ask your doctor for suggestions.

  • Control your diabetes: Diabetes raises your risk of heart disease, especially if you are careless with your medication or diet. Talk to your doctor about how you can reduce your risk.
  • Know your genetic risk: If close family members (grandparents, parents, siblings) have had heart disease, you may be at additional risk. Make sure to let your doctor know your family history. But remember, not having family members with heart disease doesn't make you immune; your lifestyle still plays a role.
  • Consider hormone replacement therapy: Women are at greater risk of heart attacks after menopause. Hormone replacement therapy (HRT) may reduce this risk but won't necessarily reverse any plaque buildup already present. Discuss with your doctor whether HRT is appropriate for you.

Even people with good health habits, though, aren't always immune. "Heart attacks often strike with little warning," says David Herrington, MD, associate professor of medicine and cardiology at Wake Forest University School of Medicine in Winston-Salem, N.C. "Knowing the signs of an attack can help you recognize the emergency and get lifesaving treatment in time."

The most common signs of a heart attack, according to the AHA are:

  • Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest lasting more than a few minutes
  • Pain spreading to the shoulders, neck, or arms
  • Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath

Women often experience these signs:

  • Atypical chest pain, stomach, or abdominal pain
  • Nausea or dizziness
  • Shortness of breath and difficulty breathing
  • Unexplained anxiety, weakness, or fatigue
  • Palpitations, cold sweat, or paleness

If you have any of the above symptoms, seek medical attention immediately and assertively ask for tests used to diagnose a heart attack, says Herrington. If it isn't a heart attack after all, you've lost nothing. But if it is, the time it takes to get treatment may make the difference between life and death.

Michele Bloomquist is a freelance writer based in Portland, Ore., who specializes in women's health issues.

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