Heart Disease Affects Women, Too
Heart disease, contrary to common perception, doesn't only affect men. It's the leading cause of death for both men and women in the United States. In fact, heart disease causes an estimated 1 in 3 deaths among women each year, and it kills more women than all forms of cancer combined.
"We have a lot of information out about breast cancer. We have a lot of commercials, we have a lot of programs out giving people [breast cancer] awareness, so everybody knows to get their mammograms, everybody knows to get checked [for breast problems]. But that [dissemination of] information is not the same for heart disease," said Bridgette C. Provost, M.D., MPH, an internal medicine-trained physician at BW Primary Care, which will be among practices housed in the new LifeBridge Health at Foundry Row facility in Owings Mills set to open this spring. "A lot of women don't think that they can get heart disease. They're more worried actually about getting breast cancer than they are heart disease. But this is the number one killer of women in this country, so it is something we need to pay attention to and something we need to understand."
A presentation by Provost on heart disease in women was the focus of LifeBridge Health's women-only "Girls Night Out!" event Feb. 2 at the Rosenbloom Owings Mills Jewish Community Center. The fun-filled event, which also featured refreshments, seated massages, a photo booth and a martini glass painting activity, coincided with American Heart Month and the American Heart Association's "Go Red for Women" campaign, which raises funds and encourages people throughout the country to sport red in support of women with heart disease.
Modifiable risk factors for heart disease-a significant buildup of plaque within the walls of the arteries which could lead to a heart attack-are the same for women and men: high blood pressure, smoking, physical inactivity, high cholesterol (which can contribute to plaque buildup), poor diet and obesity.
"A lot times, when people are sedentary, they end up with all these conditions just the same. So it shows that everything is tied together," Provost said. "When we talk about [maintaining a] healthy heart, we talk about moving. You need to exercise, you need to move around."
These risk factors can lead to one of the main causes of heart disease-diabetes. "If you have diabetes, you're three times more likely to have heart disease than someone who doesn't have diabetes," Provost said.
Modifiable risk factors can be improved with lifestyle changes, which could reduce the need for medication. However, there are risk factors beyond one's control, like your family history, race, and age.
Men have a greater risk of heart attack than women and can suffer attacks earlier. According to the American Heart Association, the estimated annual incidence of heart attack in the United States is 580,000 new attacks and 210,000 recurrent attacks, with the average ages at the first heart attack being 65.3 years for males and 71.8 years for females.
Provost says healthy estrogen levels help protect younger women from cardiovascular disease, though she cautions that "just having estrogen alone, if you have all the other risk factors" doesn't give them full protection.
As women age, and menopause becomes a factor, their risk for heart disease increases. One major risk factor, Provost says, is the use of birth control contraceptives in women who smoke. "Typically, when we give patients birth control, we always check to see if they smoke, because it increases their risk of heart disease and also blood clots, so that combination doesn't help," Provost said. "And long term, too, as women get older, the synthetic estrogens that are in birth control are not healthy for the heart."
Atherosclerosis, one of the main complications of heart disease, is a condition in which plaque buildup narrows the arteries and can disrupt blood flow to the heart as well as the brain, legs, arms or kidneys. When atherosclerosis occurs, a piece of plaque may break off, or a blood clot may form on the plaque's surface. If a blood clot is blocking blood flow to the heart, a heart attack could occur. Likewise, a stroke can occur if a clot is obstructing blood flow to the brain.
"This is a question I get asked a lot: If I have plaque, can I get it removed? No, we can't take out the plaque," Provost said. "But the goal is to prevent it from building up."
In helping women determine their risk for heart disease, doctors rely on numbers for five key areas: total cholesterol, HDL (good cholesterol), blood pressure, blood sugar and body mass index (BMI).
Generally, a BMI less than 25, a fasting blood sugar level below 100 mg/dL, and a blood pressure reading below 120/80 mm Hg are considered ideal. The American Heart Association recommends that people ages 20 and older have their cholesterol levels checked every four to six years. Test results show cholesterol levels in milligrams per deciliter of blood (mg/dL). Your doctor can explain how your cholesterol numbers impact your risk for heart disease.
Provost says women also should be aware of symptoms that are typically downplayed but could very well precede serious heart issues. Chest pain is the most recognized symptom for both men and women. But lesser-known symptoms experienced by women that may indicate heart trouble include: abdominal pain; shortness of breath; pain in one or both arms; nausea/vomiting; back, neck or jaw pain; dizziness; lightheadedness; fainting; and unusual fatigue.
"If you're getting short of breath going to your mailbox whereas you weren't before, if you're getting short of breath walking up the stairs, if you keep having this vague abdominal pain for no reason "¦ if you're noticing these things happening more consistently, then that's when you should see your doctor," Provost said. "It could really just be heartburn, but either way, we need to check."
Women and men alike can lower their risk for heart disease by eating healthier foods, exercising regularly, and quitting bad habits like smoking and drinking. Women should also schedule an annual well-woman checkup, which includes preventive services such as shots and screenings.