Heart disease is just as deadly in women as it is in men.
Are you surprised?
For decades, most Americans have thought of heart disease as a problem for men. Thanks to Hollywood, when most of us think of a heart attack, we picture a man of a certain age, sweating and clutching his chest in response to a crushing chest pain that radiates to his left arm or jaw.
Pivotal research, like the Framingham Heart Study, contributed to the association of heart disease with men — the study didn’t initially collect much data on women.
The reality is that heart disease is the No. 1 killer of women, both in the United States and worldwide. Heart disease causes one of every three deaths among women in the U.S.
Every minute a woman dies from heart disease and stroke in the U.S., yet most women think breast cancer, not heart disease, is the biggest health risk for women, when in fact, heart disease and stroke cause more deaths in women than all forms of cancer combined.
These numbers are alarming, and they should be, but it’s not all doom and gloom. The good news is that 80% of cardiovascular disease (heart disease, stroke and other diseases of the blood vessels) is preventable.
But the first step in prevention is knowing that there is a problem.
To raise awareness of the risk of cardiovascular disease to women’s health, the American Heart Association launched its “Go Red for Women” campaign in 2004, putting a spotlight on the truth about cardiovascular disease in women. As a result, awareness among women and their health care providers has really improved in the last five years.
Know the symptoms
One of the challenges we face is that women may experience different symptoms of heart disease than men. Women may not always have crushing chest pain. Sometimes their only symptoms are feelings of extreme fatigue, shortness of breath, or abdominal discomfort.
It’s easy to see how these red flags can be missed, since they are so unspecific, and could be attributed to just getting old or being overworked!
Women and their providers may not recognize these symptoms as developing heart disease. As a result, women tend to seek treatment for cardiovascular disease later than men, contributing to the fact that their mortality rate after a heart attack is worse than men’s.
For too many women, a severe or even fatal heart attack or stroke was the first recognized sign of heart disease. So, if you’re feeling exhausted or experiencing shortness of breath, get it checked out.
Tell your doctor, “I just don’t feel like myself. Can you take my blood pressure? How about an EKG?” Make sure your doctor takes the time to go over the results with you carefully.
Know your numbers
It is crucial to take steps to protect your heart health long before an emergency can arise. While many different problems fall under the umbrella term of heart disease-including coronary artery disease, heart failure, and rhythm disorders, they all have the same set of risk factors.
One risk factor is increasing age. For women, it’s important to know that our risk increases dramatically right after menopause, when estrogen levels go down. From that point on, women and men are equally affected by heart disease.
The cardiac risk factors that I think everyone should have memorized cold are blood pressure, blood sugar, and cholesterol — both the “bad” and the “good” cholesterol.
LDL cholesterol is the bad guy, and should be below 130. HDL cholesterol is the good guy and should be above 55. Ideal blood pressure is 120/80, and fasting blood sugar should be less than 100.
Ask your health care provider to test you for these risk factors, and make sure you know your numbers. Another major risk for cardiovascular disease is smoking; so if you smoke, ask your doctor or nurse to refer you to a smoking cessation program, or to prescribe medication to help you quit.
Other risk factors for heart disease include being overweight or obese, having a sedentary lifestyle, and an unhealthy diet.
Stress also contributes to heart disease. Habits aren’t easy to change, but making even small lifestyle modifications can reap tremendous benefits.
Family history of cardiovascular disease also puts you at risk, so if you have a family history of premature cardiovascular disease — meaning a heart disease or stroke before 55 in your father or brother, or before 65 in your mother or sister — let your provider know, and ask for your risk factors to be assessed.
Make your health a priority
Patients want to know: “In practical terms, what can I do?” One of the first things I say is to stop smoking. There’s no way around that one. Smoking is terrible for your blood vessels as well as for your lungs.
Incorporating more physical activity is another key step. That doesn’t mean you have to be a gym rat. It’s just as good for your heart if you walk for 30 minutes in a mall, or take a dance class. You just need to get your body moving. Aim for about 30 minutes a day, or 150 minutes a week.
Eating a healthy diet can seem like vague advice. For your heart, you want to reduce fat consumption, and incorporate four or five cups of fruits and vegetables a day.
Try to include more fish and more fiber in your diet, while reducing sugar and sodium. Learn how to read a food label, because even healthy-looking processed foods can contain a lot of extra salt and sugar. And women don’t tolerate alcohol as well as men, so moderation is key.
The next time you go for a doctor’s appointment, ask about your diet. Don’t be shy about asking to meet with a nutritionist. Small changes in your diet can really make a big difference. And ask your doctor to prescribe an exercise plan. Sometimes, a little external push can really help you to motivate.
Women are often the caretakers of everybody but ourselves. We run our households, and we memorize the birthdays and phone numbers of all our friends and family. But we also need to know our own numbers: cholesterol, blood pressure, blood sugar, and BMI (body mass index).
And we need to start taking charge of our own heart health. When it comes to our hearts, an ounce of prevention is worth a pound of cure.
Beth Oliver, DNP, RN, is Senior Vice President of Cardiac Services, the Mount Sinai Health System.
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Beth Oliver, DNP, RN