Taking Matters to Heart – Women Should Take Steps to Improve Cardiovascular Health

Q: A friend of mine recently suffered a heart attack and told me she had no idea what was happening to her at the time. Aren’t there classic signs that you are having a heart attack?

A: Many warning signs are unique to women. They include heartburn, especially in African-American women, as well as feeling lightheaded, dizzy, short of breath, and having unusual and unexplained fatigue. But women can also share symptoms common to men, such as classic chest pressure and arm, neck, and back pain.


Q: I understand that women differ not only in heart-attack symptoms, but for risk factors as well.

A: One of the ways for us to help women improve their outcomes is to make them aware of their risks for cardiovascular disease, many of which differ from men, and to be able to control them wherever possible. While both men and women share similar risk factors for cardiovascular disease — high blood pressure, high LDL cholesterol, smoking, overweight and obesity, poor diet, physical inactivity, and excessive alcohol use — some risk factors affect women differently than men, such as diabetes, birth-control pills, stress and depression, preeclampsia, and inflammation.

In the case of diabetes, the likelihood of a woman with diabetes suffering a fatal heart attack is threefold compared to a man with diabetes. Also, about 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of pregnant women are prone to developing gestational diabetes, which occurs only during pregnancy and usually disappears after birth. Many women with this condition are at greater risk for developing type 2 diabetes by middle age, and some study results have shown that women who had gestational diabetes are also at risk for cardiovascular disease.


Q: Is there a specific age when a woman’s risk factors become greater?

A: For women, age becomes a risk factor at 55. After menopause, women are more apt to get heart disease, in part because their body’s production of estrogen drops.


Q: I was surprised to learn that smoking is a big risk factor for heart disease and that some doctors put that as their number-one risk factor to address. What can you tell me?

A: I do not know your age, but the National Heart, Lung and Blood Institute claims that women who smoke and take birth control pills are at very high risk for coronary heart disease (CHD), especially those older than 35. For women who take birth-control pills but don’t smoke, the risk of CHD is not fully known.


Q: I have a very stressful job and have high blood pressure, and I’m sometimes worried that I might have a heart attack.

A: It is important for both women and men to keep their stress in check. Stress can raise your blood pressure along with the risk of a heart attack. Depression can also lead to the development of cardiovascular disease, and we know there is a higher prevalence of depression among women than men. I hope you are working with your doctor to bring your blood pressure under control.


Q: What heart health tips can you offer me?

A: Well, I already know that you have high blood pressure, but I don’t know your exact health and circumstances. Certainly, you want to lead a healthy lifestyle, which involves exercise, keeping your weight under control, eating healthy, not drinking too much alcohol, lowering your cholesterol levels, and not smoking. You should be aware of the symptoms we just discussed, and also the different risk factors that can impact your heart health. Then, focus along with your doctor in controlling any risk factors you may have. 

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