Women And Heart Disease
For years, heart disease was considered a man's disease. But postmenopausal women are just as likely to develop heart disease as men. When heart attack or stroke do occur, they are more likely to be fatal in women. Unfortunately, many women remain unaware of the extent of their risk.
In a 2009 survey by the American Heart Association found that 46% of women were unaware that heart disease is the leading cause of death among women. Only 6% of black women and 9% of Hispanic women perceive heart disease as their greatest health threat, compared to 19% among white women.
Heart disease, stroke and other cardiovascular diseases (CVD) are the No. 1 cause of death in American women. They claim almost 422,000 lives each year. By comparison, breast cancer kills about 40,600 American women each year.
Women Have Different Symptoms
Doctors have long appreciated that women often present with more "atypical" heart symptoms than men. Classic symptoms of coronary heart disease are crushing pressure-like pain in the middle of the chest, radiating down the left arm and to the jaw, sweating, and shortness of breath. Classic angina is brought on by physical exertion or emotional strain with relief by resting and relaxation.
Symptoms of heart disease in women are just as likely to be shortness of breath, fatigue, indigestion, and anxiety. African-American and white women report similar symptoms, but African-American women more often experience appetite changes, headaches, and aching arms related to coronary artery disease.
The Hormone Connection
Before menopause, circulating hormones such as estrogen are at their highest, a possible reason why women have a much lower risk of heart disease and stroke than men. After menopause estrogen levels fall and at the same time the risk of heart disease and stroke in women increases until eventually it equals that of men. This has led scientists to believe that estrogen somehow protects women's arteries, but replacing estrogen in post-menopausal women is not the answer.
Most recently, the National Institutes of Health Women's Health Initiative, the largest study of women taking HRT, determined that the increased risks of combined estrogen and progesterone (Prempro) increased risk of heart attack rather than lowering it. Added to the extra risk of breast cancer, estrogen therapy is no longer routinely recommended for post-menopausal women. The risks outweigh the benefits of preventing osteoporosis and lowering the risk for colorectal cancer.
What You Can Do
Even if you can't change certain heart disease risk factors - your age, race, and family history - you can increase you odds of good cardiac health. As you approach menopause, it becomes even more important to adopt heart-healthy practices. It's never too late to make a change, even if you've already had bypass surgery or heart attack.
In fact, most women can decrease risk in just a few months by not smoking, eating a diet that includes five or more servings of fruits and vegetables daily and foods low in cholesterol and saturated fats, and exercising for at least 30 minutes every day. Women who take medication to lower blood pressure and cholesterol levels should be careful not to miss a dose.
Menopause doesn't have to be a time of fear of this so-called man's disease. Women can prevent heart disease. Your greatest weapon is knowledge and engaging in heart-healthy behaviors.