Today is National Women's Heart Day. Women's heart disease is the number-one killer of women. The good news is that it is preventable. Theresa Brennan, MD, cardiologist, associate clinical professor, and vice chair for clinical programs with UI Heart and Vascular Center, has these comments:
At what age do women develop a risk of heart disease?
The risk of heart disease begins when we're young, even in our middle school-age years and into our teens. The incidence of having heart attacks and symptoms from heart disease in women generally begins in their late 40s to 50s, which is a little bit older than in men. The prevalence of heart disease increases as age increases and so the prevalence is highest in women who are in their 80s and 90s.
The risk factors that increase the risk of heart disease are things like:
- Diabetes
- High blood pressure
- High cholesterol
- Family history of heart disease
- Smoking
All of those things increase the risk in any person. It's really important to recognize that these risk factors begin early in life and need to be controlled early in life. That's why childhood obesity is a very important thing for us to consider. We should be mindful of our young daughters, and sons, even, about what they're eating, and what their weight is, and what sort of physical activity they're doing because the incidence of childhood obesity is markedly increasing and it's becoming an epidemic.
With childhood obesity comes risk factors like high blood pressure and diabetes which we shouldn't be seeing in these age groups. So as parents, we need to be good role models and we need to talk to our kids and make sure that they recognize that the things that they do, even as young as 10 or so or even younger, can increase the risk of having heart problems in the future. It's easier to teach young people to have good healthy lifestyles than it is to teach us as we get older.
Are heart attack symptoms for women similar to what a man might experience?
Absolutely, they can be. The symptoms of having a pressure, a tightness, a fullness in the chest that may go out to the arms or the neck and may be associated with breathing troubles or sweatiness or nausea are the typical symptoms that we think about with heart disease and they are more common in men. Unfortunately, women may have symptoms, and very commonly will have symptoms, that are not typical. So they may have isolated symptoms of sweatiness or abdominal pain or elbow pain that are not usually thought of as symptoms of heart disease. They are not recognized either by the patient or sometimes by the physician. This has led to women having less frequent diagnoses, less frequent early diagnoses, and less good care for the treatment of heart disease which is why the American Heart Association really focuses on women and heart disease, so that we can educate people that the symptoms don't occur as typically as we would see maybe with a man.
What can women do to prevent heart disease and heart attacks?
The things that we've talked about with controlling risk factors, controlling weight, being physically active, going to your physician and knowing what your blood pressure is and what your cholesterol is and whether they need to be treated, monitored, whether they are things that we can do to make them better. All of those things are very important in the prevention of heart disease. So the best thing that I would say is to lead a good heart-healthy lifestyle and make sure that your physician is involved. High blood pressure is a risk factor for heart disease and it's a risk factor that unless you have your blood pressure taken, you won't know that you have, and so it's very important to have a good doctor that sees you on a regular basis.
Will medicines lower the risk of some women having a heart attack?
Sure, there are medicines that clearly decrease the risk of someone who's never had heart disease from developing heart disease in the future. The most common medicines that we think about are cholesterol lowering medicines, the so called statin medicines. But I think it's more important for us to recognize there are lots of things we can do that are not medicine-related to decrease our risk. It's also important that we use medicines to control blood pressure and to control diabetes. And one might even argue that medicines to help people to stop smoking are medical therapy for risk factor reduction because smoking is a big risk for the development of heart disease.
Does estrogen therapy reduce the risk of heart disease in women?
We used to think so but the studies have shown that it probably doesn't, at least in the doses and kinds of medications that have been used in the studies. Right now the American Heart Association does not recommend that we use estrogens to prevent heart disease because we don't have any data that that is true and there may actually be a slight increased risk of developing heart attacks, etc., with the initiation of it. And so estrogens have a good role in the treatments of some things, osteoporosis, etc., but we don't have data to suggest that they prevent heart disease.
Is UI Heart and Vascular Center involved in any heart related studies involving women?
We certainly do a number of clinical research studies and many of those have a predominance of women, but we don't have any studies that are specifically focused on women and that's really because the diseases that occur in the heart occur in both men and women. There are clearly some, like high blood pressure in the lungs that occur more commonly in women and therefore most of the patients that participate are women.
The issue of women versus men in clinical research has been an issue for some time because many of the studies that were done initially were done predominately on men, and so it's important that these studies be done on a subset of the population that represents the population and because these diseases occur in both men and women, most of the studies are focused on both. |
