Lack of awareness on the part of both women and their physicians compounds the problem. Studies have found that:
- when women go to their doctors complaining of chest pain, they are less likely than men to be given an exercise stress test;
- women with heart symptoms or risk factors are less likely than men with a similar profile to be prescribed either statin drugs or anti-clotting drugs;
- when they report chest pain, women are less likely than men to be referred for angiography;
- women who have already been diagnosed with heart disease are less likely than men to undergo angioplasty or coronary artery bypass graft surgery.
Findings from the recent WISE (Women’s Ischemic Syndrome Evaluation) study found that classic signs of heart disease seen in men aren’t always present in women. About 60 percent of women in this study did not show signs of blockages in their coronary arteries, even though they suffered from chest pain (angina) serious enough to cause disability.
Only one third of the women evaluated had blockages in their coronary arteries that are typically seen in male patients with chest pain. Another one third showed no blockages, yet they had impaired blood flow to the heart. By contrast, the majority of men referred for coronary angiography have blockages that are visible on an angiogram.
Rather than narrowing of the arteries that blocks blood flow, women with angina are more likely to have calcium deposits in smaller vessels. The majority of women in the WISE study had no major, visible blockages but had impaired blood flow to the heart, researchers theorized, because of plaque in smaller coronary arteries.
The old adage ‘ignorance is bliss’ couldn’t be more wrong when it comes to women and their hearts. For six of every ten women the first sign of heart disease is either an acute heart attack or sudden cardiac death.
Diabetes is such a powerful risk factor that it takes away the advantage younger women have over men. Women with diabetes need to pay special attention to heart health, exercise and weight control.
Smoking is a potent risk factor for heart disease and, as smoking rates for women have increased, so too has the risk for coronary artery disease.
Advancing age and postmenopausal status are risk factors women can do little to control. But for older, postmenopausal women, obesity increases heart disease risk and can be controlled. Defined as being 30 percent or more over ideal weight, obesity is associated with insulin resistance, high cholesterol, diabetes and high blood pressure–all risk factors for heart disease.
Known as the metabolic syndrome, the cluster of obesity, insulin resistance, high cholesterol, type 2 diabetes and high blood pressure is a potentially deadly harbinger of heart disease. The good news is that most of these symptoms are reversible with diet and lifestyle changes and, for some, with medication.
Half an hour of exercise a day (and it can be as simple as taking a brisk walk) can help get rid of abdominal fat, lower cholesterol levels and strengthen the cardiovascular system.
The Mediterranean diet that emphasizes fruits, vegetables, whole grains, legumes, beans, olive oil, fish, nuts, low-fat dairy and small amounts of meat is associated with lower rates of heart disease in both women and men.
Cutting back on fast food and take-out meals, eliminating saturated fats and limiting intake of sugar from pop, ice cream, pastries, cookies and candy will help control both weight and cholesterol levels.
The heart is a symbol of love. It’s also the central pumping station that powers us with the pulse of life. As women we need to love ourselves and our hearts enough to make choices that will keep us healthy and strong into old age.
Michelle Herbert Thomas, PharmD, CDE
Clinical Director
