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Women contract heart disease in levels that surpass most men

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Coronary heart disease, heart failure and resulting stroke are the top killers of American women. In short, one woman dies every minute from heart disease. With February proclaimed American Heart Month, more women are adopting better health habits such as getting regular exercise, not smoking, and eating a more balanced diet to counter what is increasingly called the “silent killer.”

The American Heart Association (AHA) reports that in excess of 300,000 women die each year from heart attack, representing about one in every four American women. For generations, people have stereotyped the typical symptoms of heart attack as a person clutching their chest, complaining of severe pain along their left arm, and eventually falling to the ground. Cardiologists say this scenario is not common among women. Instead, women typically experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue.

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“Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure,” said Nieca Goldberg, medical director for the Joan H. Tisch Center for Women’s Health at New York University’s Langone Medical Center. Even when the signs are subtle and you think its simply indigestion or you may be coming down with the flu, Goldberg said the consequences can be deadly, especially if the victim doesn’t get help immediately. “Many women just say it’s acid-reflux or just normal aging,” she explained.  “They do this because they are scared and because they put their families first. There are still many women who are shocked that they could be having a heart attack.”

Coronary artery disease (CAD) is the most common type of heart disease and is the leading cause of heart attacks. CAD occurs when the coronary arteries that surround and supply blood to the heart lose their elasticity and become hardened and narrowed because of plaque build-up inside the artery. Called atherosclerosis, this condition causes the coronary arteries to narrow thus slowing down blood flow to the heart and causing it to beat more slowly or even stop. Here is when chest pain (angina), shortness of breath and other systems are most resonate. Until the mid 1990s, women were often not included in heart disease research, but now with more women balancing a career and family, more reliance on processed or “fast food” because of increased daily responsibilities, and more young women who smoke have all elevated heart disease as their most serious health challenge.

The new medical statistics indicate that more women die of heart disease than the next three health-related causes of death combined—including all forms of cancer. One in three American women die of cardiovascular disease, compared to one in 30 women who die from breast cancer. Only one in six American women believes that heart disease is her greatest health risk. As well, the AHA found that only slightly more than half of women are likely to call 911 if they are experiencing symptoms, but 79 percent of women surveyed said they would call 911 if someone else was having a heart attack.

The Centers for Disease Control and Prevention (CDC) reports that a heart attack strikes someone about every 34 seconds. It occurs when blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely, stemming from a  buildup of fat, cholesterol and plaque which narrow the arteries. The CDC in 2011 found that heart attacks appear to have become more common in middle-aged women over the past two decades, yet this age group historically has had a lower overall risk of heart failure or stroke than in men the same age.

A 2011 survey conducted by National Health and Nutrition Examination and reported in ScienceDaily Magazine found that middle-aged women are also showing a higher rate of stroke than men of the same age. The survey of adults aged 35 to 54 years revealed that heart attacks have decreased in prevalence among men and increased slightly among women; 2.5 percent of men and 0.7 percent of women reported a history of heart attack from 1988-1994, whereas 2.2 percent of men and one percent of women had reported a heart attack from 1999 through 2004.

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“Although men in their mid-life years continue to have a higher prevalence of myocardial infarction and a higher 10-year risk of hard coronary heart disease than women of similar age, our study suggests that the risk is increasing in women, while decreasing in men,” the authors wrote. “Therefore, intensification of efforts at screening for and treating vascular risk factors in women in their mid-life years may be warranted.”

About six percent of White, 7.7 percent of African American and 5.7 percent of Latino women have heart disease. Some 64 percent of women who die suddenly of coronary heart failure had no previous symptoms such as previous upper-body discomfort (pain in the arms, shoulders, neck or upper back), nausea, vomiting and dizziness. Less common symptoms include unusual tiredness, trouble sleeping, problems breathing, indigestion (upset stomach) or general anxiety (feeling upset or worried). Also, diabetes, obesity, high blood pressure, high cholesterol, lack of exercise and smoking are among the risk factors that put women at high risk for heart disease.

Black women are more likely to die from heart disease, according to the Office on Women’s Health at the U.S. Department of Health and Human Services (HHS), because traditionally they don’t receive the same tests and/or treatment as White women do in detecting heart disease. The HHS report also found that 49 percent of American women have the known symptoms for heart disease which include diabetes, obesity, a poor diet, little exercise and excessive alcohol use. The AHA this month reported that only 43 percent of African American women and 44 percent of Latino women know that heart disease is their greatest health risk, these finding compared to White women of which 60 percent have been informed of their risk for heart disease. Of Black women 20 years and older, 48.9 percent have cardiovascular disease, and 50 percent of Black women are said to not recognize the signs of a heart attack. Latino women are likely to develop heart disease 10 years earlier than their White counterparts, and only one in four Latinas are aware of treatment options.

The symptoms of heart disease vary within each woman, but the common signs include: Arrhythmia (”fluttering” feelings or palpitations in the chest); heart failure (shortness of breath; swelling of hands, feet and ankles, and abdominal pain); stroke (sudden weakness, paralysis, speech and sight impairment) and heart attack itself. In the latter case, the AHA recommends you not ignore severe indigestion or heartburn but, rather, notify someone or, if alone, call 911 immediately because it could be the beginning of cardiac arrest.

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Officials at City of Hope in Lancaster say smoking contributes to almost 20 percent of heart disease deaths nationwide. Brian Tiep, M.D., director of pulmonary rehabilitation at City of Hope, said smoking increases blood pressure and heart rate, increases blood clotting, decreases oxygen to the heart, damages cells that line coronary arteries and other blood vessels, lowers HDL (or “good” cholesterol) and damages the heart muscle.

“Over time, the risk of coronary heart disease can lead to chest pain, heart failure, arrhythmia, heart attack and even death,” Tiep said. “The benefits of giving up smoking are rather immediate, although most benefits require more time.”

Woman can change these unique risk factors. First, have your doctor check the low-density itpoprotein (LDL or “bad” cholesterol). High levels of LDL can result in a build-up of cholesterol in the arteries. HDL, the “good” cholesterol, is only beneficial with low triglycerides; high triglycerides and a low HDL can mean a high risk of heart disease. There are special concerns for African American women who often do not respond well to ACE (angiotensin converting enzymes) inhibitors or ARB (angiotensin II receptor blocks) when these drugs are used by themselves. Black women reportedly respond poorly if either type of drug when used in a combination with another medicine prescribed for testing hypertension, such as a diuretic or calcium channel blocker.

The AHA says that women become more vulnerable to heart disease as they get older, especially after menopause. But why do more women than men die from heart attack? Women become more vulnerable to heart disease as their bodies produce different levels of hormones related to menopause. Many women, upon entering menopause, develop weight problems they never had before. With extra weight, there is a potential for other health risks such as diabetes, high blood pressure and high cholesterol. Unmanaged stress has been linked to heart disease, therefore the AHA recommends that middle-aged and older women utilize stress management tools (ex. yoga, light exercise, regular sleep habits) to help ward off potential obstacles to good health.

There are myths some women refer to as they relate to heart disease, among the most frequent are:

— “Heart disease is for old people.” Fact is, young women who may take birth control pills and who also smoke are 20 percent more likely to develop heart disease.

— “Fit women won’t develop heart disease.” You can be thin and have high cholesterol. The AHA recommends a cholesterol check beginning at age 20 if there is a family history of heart disease.

— “I don’t have symptoms.” Sixty-four percent of women who die suddenly of heart disease had no previous symptoms.

— “Heart disease runs in my family. There’s nothing I can do.”  The AHA says a healthy diet and knowing the early signs of heart disease have since 2008 saved the lives of 627,000 women.

It’s been 10 years since the AHA launched its “Go Red for Women” campaign, and while remarkable progress has been made, Suzanne Steinbaum, M.D., cardiologist at Lennox Hospital  in New York City, said too many women don’t understand their risk for heart disease.

“We always think as women that breast cancer is our greatest risk,” Steinbaum said earlier this month. “Over the past 20 years we have seen women develop greater risk factors. Obesity, diabetes and the stress of being in the workforce. For women less than 55 years old there has been an increase in the incidence of heart disease. We want all women to say ‘I’m going to take control of my health, I’m going to take charge of my heart, I’m going to live healthy.’”

Go Red for Women will host an evening of information as well as a fashion show on March 13 from 5 to 7 p.m. at Tangram Interiors in the Pacific Mutual Building, 523 W. 6th St., downtown Los Angeles. For details, call (213) 291-7045. A 10th-anniversary luncheon will take place May 9 at 11 a.m. at the Beverly Wilshire Hotel, 9500 Wilshire Blvd., Los Angeles. Details: (213) 291-7050.

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