Heart Disease: The Top Killer of Women
By Zineb Marchoudi
Beth Israel Deaconess Medical Center Staff
“I am aware of my heart disease every day,” says 41 year-old Jane Webber who suffers from coronary artery disease (CAD) and type I diabetes. “My heart disease does not let me forget it is there.”
While Webber is aware of her heart disease today she felt blind-sided by it nearly four years ago when she suffered a heart attack at the young age of 37.
“I was in shock. I had no idea it was a heart attack. I thought it was indigestion,” Webber recalls, “I took a Pepcid and tried to go to bed.”
It wasn’t until the next morning when Webber began sweating and feeling pain in her chest that she knew something serious was happening. At the hospital, doctors confirmed she was having a heart attack.
According to the American Heart Association, almost 37% of women die each year from some type of cardiovascular disease. That’s more than six times the amount that die from breast cancer. Heart disease accounts for more deaths in the United States than any other single or group of causes.
Dr. Loryn Feinberg, a cardiologist at The Cardiovascular Institute at Beth Israel Deaconess Medical Center, says as with men, the most common heart attack symptom for women will be chest pain. However, women may be more likely than men to experience other symptoms.
“Women may present with symptoms such as shortness of breath, fatigue, upper abdominal discomfort,” Dr. Feinberg explains. “They can feel nausea, discomfort in the neck, jaw and upper back area.”
Dr. Feinberg, who is an instructor in medicine at Harvard Medical School, says one of the key issues for women is generally underestimating their risk and their symptoms.
“They tend to present later in the course of a coronary syndrome and sometimes mistake their symptoms for anxiety or another process,” says Dr. Feinberg.
While triggers for a heart attack for men often include physical exertion, triggers for women are often emotional, including stressful situations. Men and women also may have very different ways of describing chest pain.
“In some cases, women will describe their chest discomfort as sharp, burning or severe,” Feinberg explains, “while men often describe it as pressure-like, dull, or aching.”
Webber says she didn’t know how to recognize her chest pain when she was having her attack.
“There was burning in my throat. That was my chest pain. I’ve come to realize that that is my chest pain.” she says.
Webber has had three stents - small mesh tubes used to prop open arteries - put in since her heart attack four years ago. But Webber was at higher risk for CAD because of her diabetes. She also has a family history of heart disease with her father, now 65 years-old, having had four heart attacks since his 40th birthday.
Dr. Feinberg says people who have a premature family history of CAD are at greater risk.
“A premature family history means having a parent or sibling under the age of 55 in men and under the age of 65 in women who has coronary artery disease,” Dr. Feinberg says.
While you can’t control genetics, there are other things you can do to control risk factors. Dr. Feinberg says early evaluation is key. Discussing heart disease risks with a doctor and thinking about prevention in terms of controlling cholesterol, blood pressure, and diabetes are extremely important. Maintaining regular aerobic exercise and a healthy diet are also instrumental prevention tools.
Other factors impacting women specifically, according to the American Heart Association:
- Research has shown that low levels of HDL (good) cholesterol seem to be a stronger risk factor for women than for men.
- Women who smoke and use birth control have a higher risk of heart attack and stroke than non-smokers who use the pill.
- Women have an increased risk of developing high blood pressure if they are obese, have a family history of high blood pressure, are pregnant, take certain types of birth control pills or have reached menopause. African-American women have higher average blood pressure levels compared to Caucasian women.
- Diabetes mellitus — Compared to women without diabetes, women with diabetes have from two to four times the risk of dying of heart disease and are at much greater risk of having a stroke. People with diabetes often have high blood pressure and high cholesterol and are overweight, increasing their risk even more.
Webber now finds a balance with diet and exercise to stay healthy but wishes she had been more educated about the disease.
Webber says she never imagined she would have to worry about having a heart attack.
“I’m a woman and I’m so young,” she states. “And I had no idea diabetes put me at greater risk for the heart problems.”
For more information on women and heart disease, check out the American Heart Association’s Go Red For Women campaign.
Above content provided by The American Heart Association in partnership with Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted January 2009
