Women and Cardiovascular Disease
Posted on 09/27/2011
Cardiovascular disease is the number one killer of women over age 25 in the United States, regardless of race or ethnicity. The death rate from cardiovascular diseases has decreased among men, but continues to increase in women.
Women and Cardiovascular Disease
Cardiovascular disease is NOT just a man’s disease.
Cardiovascular disease is the number one killer of women over age 25 in the United States, regardless of race or ethnicity. The death rate from cardiovascular diseases has decreased among men, but continues to increase in women.
Unfortunately, only 13 percent of women identify cardiovascular disease as the greatest health problem facing women today. Most women think that breast cancer is the leading cause of death in women. But, cardiovascular disease is the single leading cause of death for women in America and most developed countries, and claims the lives of more women than all forms of cancer combined.
Women and Cardiovascular Disease Facts
Source: American Heart Association
· There are currently eight million American women living with heart disease.
· One in four women has some form of cardiovascular disease.
· One in two American women dies from cardiovascular disease: It claims the lives of nearly 500,000 women each year. That’s about one death every minute.
· Since 1984, the number of female deaths from cardiovascular disease has exceeded that of males.
· Cardiovascular disease is a particularly important problem among minority women. The death rate due to cardiovascular disease is substantially higher in African American and latino women than in Caucasian women.
· Nearly 39 percent of all female deaths in America occur from cardiovascular disease.
· This year, an estimated 345,000 women will have a heart attack. Heart attacks occur an average of 10 years later in women than in men.
· Thirty-eight percent of women compared to 25 percent of men will die within one year of having a heart attack.
· The rate of coronary heart disease in women after menopause is two to three times that of women the same age before menopause.
· Sixty-four percent of women who die suddenly because of coronary heart disease had no previous symptoms.
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What causes cardiovascular disease?
Cardiovascular disease is a broad term that includes a variety of heart and blood vessel conditions, such as coronary artery disease, peripheral arterial disease, heart attack, stroke, high blood pressure, heart valve disease, vascular disease, aorta disease, heart failure, cardiomyopathy, abnormal heart rhythms, congenital heart disease and many other heart and blood vessel conditions.
The most common cause of cardiovascular disease is atherosclerosis (sometimes called “hardening” or “clogging” of the arteries
What are the symptoms of cardiovascular disease in women?
Symptoms of cardiovascular disease tend to occur about 10 years later in women than in men.
Women often have different symptoms of coronary artery disease than men. For example, symptoms of a heart attack in women include:
· Pain or discomfort in the chest, left arm or back
· Shortness of breath is more prominent
· Weakness or syncope ( loss of consciousness)
· Unusually rapid and irregular heartbeat
· Nausea or fatigue
It is important to get help right away if any of these symptoms occur.
If you experience any of these symptoms, it is important to call your doctor, especially if these are new symptoms or if they have become more frequent or severe.
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How is cardiovascular disease associated with menopause?
After menopause, a woman’s risk of cardio- vascular disease increases. In women who have undergone early menopause (before age 50) or surgical menopause, the risk of cardiovascular disease is also higher, especially when combined with other risk factors.
Estrogen helps a woman’s body protect her against cardiovascular disease. After menopause, cardiovascular disease becomes more of a risk for women because of the reduced level of estrogen in the body.
A reduced level of estrogen causes:
· Changes in the walls of the blood vessels that may cause plaque and blood clots to form
· Changes in the level of lipids (fats) in the blood: Levels of low density lipoproteins (LDL, the “bad” kind) increase, and levels of high density lipoproteins (HDL, the “good” kind) decrease. These changes lead to the build-up of fat and cholesterol that contributes to heart attack and stroke.
· An increase in fibrinogen (a substance in the blood that helps the blood to clot). Increased levels of blood fibrinogen are related to cardiovascular disease and stroke.
What are the other risk factors for heart disease in women?
In addition to menopause, nonmodifiable risk factors (those that cannot be changed) include:
· Older age. Once a woman reaches the age of 50 to 52 (about the age of natural menopause), the risk of heart disease increases dramatically. At age 70 and beyond, men and women are equally at risk.
· Family history of cardiovascular disease. If your parents have/had cardiovascular disease (especially if they were diagnosed before age 50), you have an increased risk of developing it. Ask your doctor when it’s appropriate for you to start screenings for cardiovascular disease so it can be detected and treated early.
· Race. African Americans have more severe high blood pressure than Caucasians, and therefore have a higher risk of cardiovascular disease. Cardiovascular disease risk is also higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This is partly due to higher rates of obesity and diabetes in these populations.
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Modifiable risk factors (those you can treat or control) include:
· Cigarette smoking or exposure to tobacco smoke
· High blood cholesterol and high triglyceride levels, especially high LDL/bad cholesterol (over 100 mg/dL) and low HDL/good cholesterol (under 40 mg/dL). Some patients who have existing heart or blood vessel disease and other patients who have a very high risk should aim for an LDL level less than 70 mg/dL. Your doctor can provide specific guidelines.
· High blood pressure (140/90 mm Hg or higher)
· Uncontrolled diabetes
· Physical inactivity
· Being overweight (body mass index [BMI] 25-29 kg/m2) or obese (BMI higher than 30 kg/m2)
NOTE: How your weight is distributed is also important. Your waist measurement is one way to determine fat distribution. Your waist circumference is the measurement of your waist, just above your navel. The risk of cardiovascular disease is higher for women with a waist measurement over 35 inches (over 32 inches for Asian Americans) and men with a waist measurement over 40 inches (over 38 inches for Asian Americans).
· Uncontrolled stress or anger
· Diet high in saturated fat and cholesterol
· Drinking too much alcohol
Unique risk factors for women include high blood pressure or diabetes while pregnant (gestational diabetes), polycystic ovary disease and autoimmune diseases such as rheumatoid arthritis or lupus.
The more risk factors you have, the greater your overall risk.
· Increase your exercise/activity level to help achieve and maintain a healthy weight and reduce stress. Moderate exercise for 30 minutes a day, on most days is recommended. Check with your doctor before starting an exercise program. Ask your doctor about participating in a cardiac rehabilitation program.
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Hormone replacement therapy (HRT). For many years, preliminary observational research showed that hormone replacement therapy (HRT) could possibly reduce the risk of heart disease in women. It appears that the reason why the observational studies showed a reduced risk of heart disease was likely due to the lifestyles of women who take HRT rather than medical benefits of the therapy.
More recent large-scale studies of women, such as the Heart and Estrogen/Progestin Replacement Study (HERS) and the Women’s Health Initiative (WHI) concluded that the overall health risks of HRT exceeded the benefits.
Women who participated in HERS had an increased risk of heart attack and stroke during the first year of HRT. After two years of treatment, this risk appeared to be reduced in women taking HRT compared with women who were not taking HRT.
Women who participated in the WHI study had an increased risk for breast cancer, coronary heart disease (including nonfatal heart attacks), stroke, blood clots and gallbladder disease.
Based on the results of these studies, the American Heart Association and the U.S. Food and Drug Administration developed new guidelines for the use of HRT:
· Hormone replacement therapy should not be used for prevention of heart attack or stroke.
· HRT should be used to alleviate symptoms caused by the menopause, such as hot flashes, sweating, palpitations, irritability, inability to sleep, etc.
· Use of HRT for other problems such as preventing osteoporosis should be carefully considered, and the risks should be weighed against the benefits. Women who have existing coronary artery disease should consider other prevention options.
· Short-term HRT may be used to treat menopausal symptoms.
· Long-term HRT use is discouraged because the risk of heart attack, stroke and breast cancer increases the longer HRT is used.
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