Heart Disease

There was a time when heart disease was considered a disease that only affected men. Today, however, we know heart disease in women is an all too common phenomenon.
An estimated 42 million American women live with cardiovascular disease, but too many are unaware of the threat they face. Cardiovascular disease, including heart disease and stroke, is the number one cause of death to women in the United States over the age of 65. By the time they reach 65, one-third of American women have heart disease.
Because heart disease in women is such a serious problem, it is important for you to become familiar with the risk factors associated with it and how to lower your likelihood of developing heart disease.

Risk Factors

Heart disease is the leading cause of death in women over the age of 55 and the leading cause of death in African American women over the age of 30. Cardiovascular disease, including heart attack, stroke, high blood pressure, congestive heart failure or angina (chest pain), account for the deaths of 50,000 American women each year. Coronary artery disease (blockage of the arteries of the heart) accounts for 250,000 deaths of American women annually. While one out of eight women develops breast cancer, one out of three women eventually dies from coronary artery disease. However, women tend to fear breast cancer more than heart disease. Women may tend to accept heart disease as a natural part of aging.
Fewer women are referred for non-invasive cardiac testing, cardiac catheterization and bypass surgery than men. These gender differences may be due to the way a woman's symptoms are perceived, evaluated and/or acted upon by both the woman and her physician. Women tend to recognize the changes in their bodies more often than men and see their doctors more regularly. This may lead to delusion of the woman's symptoms, making the diagnosis difficult for the physician unless he or she is considering heart disease within differential diagnosis.
Women usually experience heart disease approximately 10 years later than men. This may be because the hormone estrogen provides some protection to women. When taken after menopause, estrogen may reduce the incidence of heart disease by 50 percent. However, there are some risks associated with taking estrogen. Check with your doctor if you are interested in learning more about the pros and cons of estrogen therapy.
Women with heart disease have angina more often than men. Angina may be felt as crushing chest pressure, squeezing chest tightness, arm aching, pain or numbness, increased fatigue, lightheadedness, sweating, neck or jaw aching or pain, nausea, pain or ache between the shoulder blades or shortness of breath. Sometimes, especially in diabetic people, there are no symptoms.
Heart attacks in women are more often fatal than in men. Once a woman has had a heart attack, she is more likely than a man to have a second heart attack, often within the first year. Women more often have unrecognized or silent heart attacks than men. Of women with heart attacks, African American and diabetic women have the worst prognosis.

Additional Risk Factors

Family history, age, gender and race are non-modifiable risk factors associated with heart disease. Women have an elevated risk of heart disease if their mother, father, an uncle or a sibling had a heart attack or stroke before the age of 60. By the age of 70, women have an incidence of heart disease equal to men.


Smoking is one of the most preventable causes of heart disease. Smoking as few as four cigarettes per day doubles cardiovascular risk. Smoking one pack per day increases cardiovascular risk 15 times over the non-smoking rate. Women smokers on oral contraceptives are 30 times more likely to have a heart attack and 22 times more likely to have a stroke than non-smokers on oral contraceptives. Other illnesses linked to smoking include various cancers, bronchitis and emphysema. Smoking has also been linked to low infant birth weight and to sudden infant death syndrome.
There is no safe way to smoke. Chewing tobacco or snuff is just as dangerous as smoking because of the nicotine contained in the products. If you smoke, ask your doctor for help in quitting. There are a number of programs or organizations, such as Clear Direction, a smoking cessation program offered at Health Zone at Saint Francis, designed to help you quit smoking for good.
The risk of death drops immediately after you stop smoking, and the risk of heart disease declines rapidly. Three to five years after quitting smoking, the risk of heart disease is the same as a nonsmoker.

High Blood Pressure

High blood pressure, also known as hypertension, is more common in women than men. It has been called the "silent killer" because people who suffer from it usually do not feel sick.

An increase in blood pressure by 10mmHg increases cardiovascular risk by 20 percent. Blood pressure should be less than 140-190 mmHg. Treatment of high blood pressure reduces the risk of heart attack and stroke. Blood pressure may be reduced by avoiding alcohol and salt, exercising regularly and losing weight. In addition, relaxation techniques may be helpful to reduce stress and lower blood pressure. However, prescription medication may also be needed.


Women with diabetes are at an increased risk of developing coronary heart disease. Eighty percent of diabetics die from cardiovascular disease.

If you have diabetes, it is important to maintain an ideal body weight. Eat a low-fat, low-cholesterol diet, exercise regularly and screen for coronary blockages. Diabetic women also often have high blood pressure and high blood lipids, both additional risk factors for coronary heart disease.

High Blood Cholesterol

High blood cholesterol is another of the most preventable causes of coronary heart disease. Cholesterol most often rises in women who are near 40 years old and increases until about age 60.

The best predictor of heart disease in women is the ratio of total cholesterol to HDL cholesterol (good cholesterol). Women with higher HDL cholesterol levels have a lower incidence of heart disease. Triglycerides (a fatty energy source for the body) are an independent risk factor for heart disease in women.

Cholesterol should be below 200mg/LD. The LDL cholesterol (bad cholesterol) should be below 130. The HDL cholesterol should be approximately 50 in women and greater than 35 in men. Triglycerides should be less than 150 when fasting.

Cutting back on foods rich in fat and cholesterol can lower your total and LDL cholesterol levels. Weight loss and increased physical activity may also lower blood cholesterol levels. You should avoid alcohol, which can increase your triglycerides. Antioxidants, such as vitamin E, are useful in preventing the oxidation of LDL, and can help prevent heart disease in women, as well as men.

It may be necessary for you to take cholesterol-lowering medication. Your physician should advise you on the best approach to lowering your total and LDL cholesterol levels, and raising your HDL cholesterol level.


Obesity in women is linked to coronary heart disease, stroke, congestive heart failure and death from all types of heart-related causes. Women who are mildly to moderately overweight have twice the risk of heart disease as women who are at their ideal weight. The more obese you are, the greater your risk of heart disease. Also, central truncal obesity (excess weight in the waist) has greater cardiovascular risk than peripheral obesity, where excess weight is carried in the hips and thighs.

A combination of diet and exercise may help you lose weight. Your physician may be able to make recommendations about the nutritional needs, as well as physical activity levels.

Lack of Physical Activity

Lack of physical activity increase the risk of developing heart disease. Performing 30 to 60 minutes of activities such as brisk walking, swimming, biking or aerobics three times a week can decrease the risk of coronary artery disease by 40 percent. Sedentary women have nine times higher risk of dying from heart disease than women who are fit.

If you are interested in beginning a physical exercise program, you may be interested in Health Zone at Saint Francis. You should always consult your doctor before starting an exercise program.


People with Type A personalities, who experience more anger, hostilities or stress in their life, are at an increase cardiovascular risk. Career choices also seem to play a role in stress. Women with clerical jobs appear to have twice the number of heart attacks as women in other jobs. Better educated women tend to have fewer heart attacks than less educated women.

People who participate in stress reduction therapy have fewer recurrent heart attacks. Relaxation techniques can help reduce stress, as well as lower blood pressure.

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