When most of us think of a heart attack victim, chances are, we picture a man. However, a woman’s risk of having a heart attack is higher than a man’s — and heart attacks are still the leading cause of death among women.
Cardiovascular disease is the number-one killer of women over age 40, and the risk rises with age. Despite this evidence, just 34 percent of women in a 2000 national American Heart Association survey correctly named heart disease as a leading cause of death — and only 8% could identify it as their number-one health threat.
Traditionally, men have gotten the bad rap for their reluctance to visit the doctor, and the stereotype of the negligent male patient and the more health-conscious wife, daughter or girlfriend endures. However, the rate of heart disease and related risk factors are actually increasing in women, and decreasing in men. There are many reasons for this disparity.
Atypical symptoms
Heart attack symptoms for women can be different than those that typically occur for men and often, women dismiss these symptoms as being a sign of stress, a panic attack or fatigue. Traditional symptoms — chest pain, pain down the left arm. Atypical symptoms — stomach ache, nausea or vomiting, unexplained sweating, unusual shortness of breath and fatigue
Biological factors
Certain biological factors that only affect women carry a certain degree of heart disease risk.
• Health occurrences during a woman’s pregnancy — once thought to have no significant bearing on her long-term health — now have been determined to be contributing risk factors for heart problems. A woman who develops preeclampsia (pregnancy-induced hypertension), gestational diabetes, or high blood pressure during pregnancy increases her risk for glucose intolerance, obesity, diabetes and hypertension later in life — all risk factors for heart disease. In fact, according to the National Heart, Lung & Blood Institute, 80% of women ages 40 to 60 have at least one risk factor for heart disease.
• Menopause is also thought to contribute to elevated heart disease risk, because in addition to the drop in estrogen production, post-menopausal women also experience changes in the walls of the blood vessels (making it easier for plaque and blood clots to form), a drop in HDL (good) cholesterol and an increase in LDL (bad) cholesterol, and an increase in the level of fibrinogen in the blood, a substance that makes it easier for the blood to clot.
• Some heart conditions affect only women due to the structure of a woman’s heart, and women often have a more difficult recovery, post-heart attack. Recent studies have shown that a type of heart disease known as coronary microvascular disease (MVD), which affects the heart’s smallest arteries, is more common in women. And, standard tests for coronary heart disease don’t always detect MVD in women, according to the National Heart, Lung & Blood Institute. Thus, women once thought to be at lower risk for heart disease may have actually gone undiagnosed.
• Finally, women are more likely than men to suffer depression following a heart attack, and are less successful at adopting new — and healthier — lifestyle habits. Therefore, their risk of a repeat heart attack is higher.
Dr. Rubina Mirza is a cardiologist at Poplar Bluff Regional Medical Center.