Every minute in the United States, a woman dies from heart disease, stroke or other form of cardiovascular disease (CVD). And more than one in three women is living with CVD, including nearly half of all African-American women and 34 percent of white women. Although heart disease death rates among men have declined steadily over the last 25 years, rates among women have fallen significantly less.
Dr. Shephal Doshi is the director of cardiac electrophysiology and pacing at St. Johns Health Center in Santa Monica and he spoke with Maggie McKay and Michael Shappee to discuss this important health news:
Learn more about Wear Red Day.
Cardiovascular Disease: Women’s No. 1 Health Threat
A 2009 survey conducted by the AHA found that 46% of women were unaware that heart disease is the leading cause of death among women. In addition, women of color and of low socioeconomic status are disproportionately affected by coronary heart disease; the death rate was 28% higher for black women than for white women in 2008.
However, only 43% of black women and 44% of Hispanic women know that heart disease is their greatest health risk, compared to 60% of white women. Many women also do not recognize the warning signs or symptoms of heart disease, which may be subtler than those exhibited by men. In addition, only 53% of women said the first thing they would do if they thought they were having a heart attack was to call 911.
Unfortunately, this lack of awareness extends to women’s health care providers, often resulting in less aggressive and sophisticated diagnosis and treatment, with worse outcomes.
• Women tend to develop CVD later in life than men, and their outcomes are often worse. Women smokers die of a heart attack caused by smoking earlier than men.
• Women with acute coronary syndrome are more likely to have adverse outcomes, including death, heart attack, stroke, or re-hospitalization, even after adjusting for age differences.
• Previous studies and clinical trials have often been done with inadequate numbers of women in the study population, and thus, their conclusions do not always apply to women. Women represent just 38% of subjects in NIH funded cardiovascular studies. In addition, three-fourths of cardiovascular clinical trials do not report sex-specific results, making it difficult for researchers and clinicians to draw conclusions about their effects on women. Likewise, in an analysis of more than 120 studies of 78 FDA-approved medical devices between 2000 and 2007, women made up only one-third of the participants in the studies and 28% of the studies didn’t provide the gender of the patients enrolled in the trials.
• Researchers have identified gender differences in response to cardiac medications.
• Drugs that are beneficial for men may even be harmful to women. For example, the drug digoxin used to treat patients with heart failure was associated with an increased risk of death among women, but not men.
• Women are less likely than men to receive aggressive diagnosis and treatment for CVD.
• Women who are at risk for CVD are often not referred for diagnostic testing that would be standard in men.
• Among Medicare patients, men are two to three times more likely than women to receive an implantable cardioverter-defibrillator for the prevention of sudden cardiac death.
• Only about 34% of all percutaneous coronary interventions, with and without stent insertions, were performed on women in 2009.
Do You Know Your Numbers?
Total Cholesterol: <200 mg/dL
LDL “Bad” Cholesterol:
• Optimal: <100 mg/dL
• Near optimal/Above Optimal: 100-129 mg/dL
• Borderline High: 130-159 mg/dL
• High: 160-189 mg/dLVery High: 190 mg/dL and above
HDL (“Good”) Cholesterol: 50 mg/dL or higher
Triglycerides: <150 mg/dL
Blood pressure: <120/80 mmHg
Fasting Glucose: <100 mg/dL
Body Mass Index (BMI): <25
Waist Circumference: <35 inches
Women and Heart Disease Prevention Month – WEAR RED!
Wear red in February for American Heart Month and National Wear Red Day (the first Friday in February) to help raise awareness about heart disease, but don’t stop there. Make sure you know the signs of a heart attack, ask your doctor questions about heart health, and learn how to lower your risk for heart disease.
Having high blood pressure or high blood cholesterol, smoking, and having had a previous heart attack, stroke, or diabetes can increase your chances of having a heart attack.
Lower Your Risk for Heart Disease
Eating healthy, staying active, being smoke-free, and getting regular check-ups are simple steps you can take to lower your risk for heart disease.
Know the risk factors that may increase your chances of getting heart disease.
• High blood cholesterol levels
• High blood pressure
• Physical inactivity
• Tobacco use
Take this list to your next doctor’s appointment, and get the answers.
• What is my risk for heart disease?
• What is my blood pressure? What does it mean for me, and what do I need to do about it?
• What are my cholesterol numbers (including total cholesterol, LDL or “bad” cholesterol, HDL or “good” cholesterol, and triglycerides)? What do they mean for me, and what do I need to do about them?
• What is my “body mass index” and waist measurement? Is my BMI in the “normal” range? Do I need to lose weight for my health?
• What is my blood sugar level? Am I at risk for diabetes?
• What other screening tests for heart disease do I need? How often should I return for checkups for my heart health?
• What can I do to quit smoking?
• How much physical activity do I need to help protect my heart?
• What is a heart-healthy eating plan for me? Should I see a registered dietitian or qualified nutritionist to learn more about healthy eating?
• How can I tell if I’m having a heart attack?
Know the Signs, and Act Immediately
A woman suffers a heart attack every 90 seconds in the United States. If you think you or someone you know is having a heart attack, call 9-1-1 immediately. The good news is that if you seek help quickly, treatment can save your life and prevent permanent damage to your heart muscle. Treatment works best if given within 1 hour of when symptoms begin.
Common symptoms are:
• Unusually heavy pressure on the chest, like there’s a ton of weight on you
• Sharp upper body pain in the neck, back, and jaw
• Severe shortness of breath
• Cold sweats (not hot flashes from menopause)
• Unusual or unexplained fatigue (tiredness)
• Unfamiliar dizziness or light-headedness
• Unexplained nausea (feeling sick to the stomach) or vomiting