Heart Disease
Women and Men Differ in Affairs of the Heart!
by Mary Jo Blackwood, RN, MPH

    While relationship therapists spend time explaining the differences in how men and women communicate, cardiologists are also concerned with affairs of the heart —specifically diagnosing and treating heart disease symptoms that may present differently in men and women. There is a lot women need to know about their particular risk and treatment of heart disease.
    Every year, 500,000 women die from cardiovascular disease. Those diseases including coronary artery disease (blockages), stroke, peripheral artery disease and heart failure. That’s more than the six other leading causes of female mortality combined. Over her lifetime, a woman has a one-in-two chance of developing cardiovascular disease. One in three die from it. The chance of death due to breast cancer is one in thirty.
    “Women tend to be older when they develop cardiovascular disease because of the protective effects of their natural estrogen and may, in general, tend to minimize symptoms,” said Andrew M. Kates, M.D. Kates is the medical director for the Heart Disease Prevention program at Washington University. He says that because their onset of heart disease is about 10 years later than men, women are more likely to have other conditions due to their age.
    While both women and men may experience chest pain during a heart attack, women may have other symptoms that are not so clear-cut:
•    chest tightness
•    nausea
•    fatigue
•    pain with exertion and at rest
•    upper abdominal pain or pain predominately in the neck or back
    According to the Women’s Heart Foundation, almost a third of women experience no chest pain at all when having a heart attack, and almost three-fourths report flu-like symptoms for up to a month prior to the attack. Kates says that in addition to traditional blockages, women may have other heart-compromising conditions. These include coronary artery spasms, which can also behave like a blockage.

Conditions that Raise the Risk for
Cardiovascular Disease in Women

Hypertension: One-half of women over 45 have high blood pressure.
Cholesterol: Low HDL (good cholesterol) and high triglycerides increase the cardiovascular risk disproportionately for women, especially over the age of 65.
Smoking: Premenopausal women who smoke are in one of the highest risk categories.
Diabetes: In diabetics, both men and women at any age are equally at risk.
Hormone Replacement Therapy (HRT): For women with cardiovascular disease, there is no cardiovascular benefit to HRT. It can actually increase risk.

Kates has this advice for women:

•    Know those risk factors.
•    Know the symptoms of serious heart problems and how they may be different from men’s.
• Understand that post-menopause, your risk greatly increases.
•    Dedicate yourself to eliminating modifiable risk factors: smoking; unhealthy diet; get your cholesterol and blood pressure under control.
• Commit to life-long exercise: at least 30 minutes a day, five days per week at moderate intensity.
    If you think you are having symptoms of a heart attack, act! But don’t drive yourself to the hospital.
    Be your own advocate for aggressive treatment of a heart attack.

Andrew M. Kates, M.D., medical director for the Heart Disease Prevention program at Washington University