What Women
Don't Know About
Heart Attacks can
Harm Them

Taking Depression
to Heart

Making Your
Heart Health a
Primary Concern

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About Women's Health

After a heart attack, women are even more vulnerable. Thirty-eight percent of women, compared with 25% of men, die within one year following a heart attack. Several factors make women vulnerable. “Since, as a group, women live longer, they are older, which is a risk factor. Women also are more likely to have other risk factors such as high blood pressure or diabetes, which increase risk,” says Dr. Claire Duvernoy, a cardiologist at the University of Michigan Health System. “In addition, research also shows that women are more vulnerable to the complications associated with the treatments for their attacks. Sometimes this causes physicians to recommend less aggressive treatment for women who have a heart attack.”

Most women also are unaware that heart disease does not strike all women equally. Cardiovascular disease (CVD) is more common among some minority women. For example, 79% of elderly African-American women have high blood pressure, a risk factor for heart disease.

The Challenges of Diagnosis
Diagnosing a heart attack presents an additional challenge. While most women recognize chest pain, shortness of breath, and pain in the left arm as signs of a heart attack, they often experience the less common symptoms. This makes diagnosis difficult. Dr. Duvernoy notes that women need to know that symptoms of a heart attack also may include:
• dizziness
• fatigue
• nausea
• abdominal pain.
The conventional electrocardiogram (EKG) stress test often is not the best diagnostic tool for women. Nuclear and ultrasound imaging stress tests can be more useful. One diagnostic tool, an echocardiogram, or ultrasound of the heart, is proving to be especially accurate for women.

Controlling Risk Factors
Some risk factors, such as aging and heredity, are difficult to control. However, women can modify risk by changing habits. Here are some important things you can do:

Quit smoking. More than 50% of middle-aged women who have had heart attacks are smokers. In fact, cigarette smoking is one of the biggest risk factors for sudden cardiac death. If a woman makes only one lifestyle change, she should quit smoking.

Control cholesterol levels. Women normally have lower cholesterol levels than men, but when women have high cholesterol their risk for heart attack is higher. Low levels of “good” cholesterol (HDL) are a stronger predictor of death from heart disease in women than in men.

Maintain a healthy weight. Excess weight increases the strain on the heart, raises blood pressure, blood cholesterol and triglyceride levels, and lowers “good” cholesterol. People who have excess body fat, especially in the waist area, are more likely to develop heart disease.

Control blood pressure. High blood pressure increases the heart’s workload, causing it to enlarge and weaken over time. When high blood pressure exists with obesity, smoking, high blood cholesterol levels, or diabetes, the risk of heart attack or stroke increases several times.

Eat healthy. The lower incidence of heart disease in Mediterranean countries indicates that this eating style may be a healthier menu option for some people. Although this diet contains a higher percentage of calories from fat than recommended, more than half of these fat calories come from monounsaturated fats, such as olive oil, which raise blood cholesterol levels less than saturated fat.

Get moving. A sedentary lifestyle is an important heart attack risk factor. Walking—as little as three hours a week—is a significant step toward better health. Exercise helps control blood cholesterol, blood pressure, diabetes, and obesity, which are all important risk factors.

Monitor diabetes. Women who have diabetes have three to seven times more risk of heart attack. Plus, more than 80% of people with diabetes die of some form of heart or blood vessel disease. If you have diabetes, it’s critical to work with your physician to manage the disease.

Have a positive attitude. Take steps to avoid stress and depression. New research is showing that women have a more difficult time overcoming the negative effects of stress on the body. Plus, women are more vulnerable to depression after a heart attack, which decreases their survival rates.

In the battle against heart attack, a woman’s best defense is her understanding of the facts. That’s her first step to controlling risk.