Women Should Take Steps to Prevent Heart Disease

Since 1910, with the exception of a few years dominated by the 1918 flu pandemic, heart disease has been the leading cause of death in the U.S. every year. Advances in medical knowledge and technology have greatly reduced deaths from heart disease, but it still remains — more than century later — the number-one cause of death.

The startling fact is that heart disease — or, more specifically, cardiovascular disease (CVD) — has become predominantly a women’s disease. CVD is now the number-one cause of death of women in the U.S., claiming some 400,000 lives each year — more than all cancers combined. And since 1984, more women than men have died each year from these conditions, according to the American Heart Assoc.

It’s important to note that cardiovascular disease involves more than just conditions of the heart alone. CVD applies to any condition related to the heart; it can include stroke, blood-vessel disease, blood clots, valve disease, or blockages in arteries, as well as heart attacks. And those conditions are widespread: cardiovascular conditions affect an estimated 43 million women, and 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} have one or more risk factors for developing CVD.

The troubling part is that too many women — 44{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} — are unaware that CVD is the number-one threat to their health.

One reason women have been slow to recognize the threat of CVD is that most of the research has excluded women, as heart disease was thought to be a condition mainly affecting men. Including women in research studies in recent years has raised our knowledge of women’s risks for CVD.

One of those risks is family history. Heart disease in a father, mother, sister, or brother is a particular concern, and the details of that history are important. Another primary risk factor is age: as women age, the risk for heart disease rises. High blood pressure, high cholesterol, and diabetes are additional risk factors.

We also know that gender differences exist in heart disease. The symptoms of CVD can present differently in women than in men; women, for example, are less likely to report chest pain when having a heart attack. Race and ethnicity are factors as well. Hispanic women are likely to develop CVD much earlier than Caucasian women, and among African-American women 20 and older, 47{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} have cardiovascular disease.

Cardiovascular conditions can also have serious implications for pregnancy. About 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of women are subject to pre-eclampsia, a pregnancy complication characterized by high blood pressure that can lead to premature delivery and difficulties for both mother and child. Pre-eclampsia can also raise the long-term risk for CVD, so these patients should pay particular attention to their heart health.

Many reasons, then, exist for women to learn more about cardiovascular disease. The good news is that many of the risks can be prevented or controlled. Good heart health can be achieved by eating a healthy diet, exercising, not smoking, maintaining a healthy weight, limiting alcohol, keeping cholesterol and blood-pressure levels in check, and getting screened for diabetes.

Another key step is partnering with your healthcare provider. Many women don’t go to their physician or nurse practitioner regularly. It’s important to have that partnership, stay on top of cholesterol and blood pressure levels, be aware of the risks, and manage those risks daily.

When you visit your provider, we recommend you bring two things: a list and a listener. The list, prepared before the visit, should have all the questions you want your doctor to answer. The listener, a family member or close friend, can be critical in taking notes and reminding you about important parts of the discussion.

Above all, women should take time to take care of themselves. Many women are raising children, taking care of parents and spouses, and working. In trying to do all those things, they forget to care for themselves. They don’t pay attention to blood pressure, cholesterol, how much they weigh, how much they drink, or how much stress they may be under.

All women should talk with their healthcare provider about heart disease and get screened for cardiovascular disease. It’s worth repeating: the majority of CVD is preventable. Women need to take the necessary steps in preventive care, find people around them to support healthy habits, and take care of themselves.

For more information, visit the American Heart Assoc. at www.goredforwomen.org. For a video discussion, visit www.physicianfocus.org/womensheart.

Dr. Malissa Wood and Dr. Nandita Scott are co-directors of the Corrigan Women’s Heart Health Center at Massachusetts General Hospital in Boston. This article is a public service of the Mass. Medical Society.

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