Women and Heart Disease

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The risk of heart disease in women increases with age. Heart disease is the leading
cause of death in women over 40 years old, especially after menopause. Every year,
more than 400,000 U.S. women die of heart disease. This translates to approximately
one death every minute.

Why Does a Woman's Risk of Heart Disease Rise With Age?

Menopause is a normal stage in a woman's life; it comprises any of the changes a
woman experiences either before or after she stops menstruating. As menopause
nears, the ovaries gradually produce less estrogen (a female hormone), causing
changes in the menstrual cycle and other physical changes.
The most common symptoms of menopause are hot flashes, night sweats, emotional
changes, and changes in the vagina (such as dryness).
Menopause usually occurs naturally in women between ages 45 and 55. However, loss
of estrogen can also occur if the ovaries are removed during surgery (such as during a
total hysterectomy) or if a woman goes through early menopause.

Why Is Heart Disease Associated With Menopause?

The loss of natural estrogen as women age may contribute to the higher risks of heart
disease seen after menopause. Other factors that may play a role in postmenopausal
risks of heart disease include:

Changes in the walls of the blood vessels, making it more likely for plaque and

blood clots to form.

Changes in the level of fats in the blood (LDL, or "bad" cholesterol increases and

HDL, or "good" cholesterol decreases).

Increases in fibrinogen levels (a substance in the blood that helps the blood to
clot). Increased levels of blood fibrinogen are related to heart disease and stroke since it
makes it more likely for blood clots to form, narrowing the arteries and reducing blood
flow to the heart.

How Can Menopausal Women Reduce Their Risk for Heart

Disease?
First and foremost, "traditional" risk factors for heart disease should be addressed after
menopause. Women with the lowest risk of heart disease are those who:

Avoid or quit smoking.

Lose weight and/or maintain their ideal body weight.
Exercise for for more than 30 minutes more than three times per week.
Follow a diet low in saturated fat (<7% daily amount); low in trans-fat (partially
hydrogenated fats such as margarine or shortening); and high in fiber, whole grains,
legumes (such as beans and peas), fruits, vegetables, and fish.
Treat and control medical conditions such as diabetes, high cholesterol, and high
blood pressure that are known risk factors for heart disease.

Can Hormone Replacement Therapy (HRT) Reduce My Risk of

Heart Disease?
For many years, research was thought to show that hormone replacement therapy
(HRT) could possibly reduce the risk of heart disease in women by replacing the
estrogen lost during menopause.
More recent studies of women with existing heart disease have not shown benefits after
4 years of HRT use. In fact, data are showing that some forms of HRT may be harmful
in these women.
Experts no longer recommend HRT to protect postmenopausal women against heart
disease.

Sweating. Pressure. Nausea. Jaw pain. Believe it or not, these are all symptoms of a heart attack in
women. They are also symptoms that women often brush off as the flu, stress or simply feeling under
the weatherwhich could put their lives in jeopardy.
I really couldnt believe this happened to me, says survivor Amy Heinl. I thought of myself as a
healthy person, and was exercising when [my heart attack] happened.
Whether its disbelief, lack of awareness or misdiagnosis, dismissing the symptoms of a heart attack
can delay critical, life-saving actions. Being able to recognize the warning signs and act quickly,
however, can save a life.

Causes of a heart attack in women

Heart attacks occur when the flow of blood to the heart is blocked by a buildup of plaque in coronary
arteries. While the initial causation can often be pinned on the usual suspectsheavy smokers,
people with high-stress lifestyles, or those who are excessively overweightthe not-so-usual suspects
can also be at high risk for heart attack.
Heart disease is the No. 1 killer of women, which is why it is imperative that women learn the
warning signs and symptoms, see a doctor regularly, and learn their family history.

Symptoms of a heart attack:

Uncomfortable pressure, squeezing, fullness or pain in the center of your chest that lasts
more than a few minutes, or goes away and comes back.

Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath, with or without chest discomfort.

Other signs such as breaking out in a cold sweat, nausea or lightheadedness.

As with men, the most common heart attack symptom in women is chest pain or discomfort. But its
important to note that women are more likely to experience the other common symptoms,
particularly shortness of breath, nausea/vomiting and back or jaw pain.

What to do during a heart attack

If you experience any of these signs or symptoms:

Do not wait to call for help. Dial 9-1-1, make sure to follow the operators instructions and get
to a hospital right away.

Do not drive yourself or have someone drive you to the hospital unless you have no other
choice.

Try to stay as calm as possible and take deep, slow breaths while you wait for the emergency
responders.

Why its important to know the symptoms of a heart

attack

Women who consider themselves healthy often misdiagnose the symptoms of a heart attack because
they dont think it could happen to them. That is why its crucial to learn about heart disease
and stroke, know your numbers, live a heart-healthy lifestyle and be aware of the risk factors of heart
disease.
For more information about heart attacks in women, check out our article on Common Questions
about Heart Attack Symptoms.

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6 Symptoms of Women's Heart Attacks

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By Lisa Fields
WebMD Feature
Reviewed by Brunilda Nazario, MD
When a heart attack strikes, it doesnt always feel the same in women as it does in men.
Women don't always get the same classic heart attack symptoms as men, such as
crushing chest pain that radiates down one arm. Those heart attack symptoms can
certainly happen to women, but many experience vague or even silent symptoms that
they may miss.
These six heart attack symptoms are common in women:
1.

Chest pain or discomfort. Chest pain is the most common heart attack
symptom, but some women may experience it differently than men. It may feel like a
squeezing or fullness, and the pain can be anywhere in the chest, not just on the left
side. It's usually "truly uncomfortable" during a heart attack, says cardiologist Rita
Redberg, MD, director of Womens Cardiovascular Services at the University of
California, San Francisco. "It feels like a vise being tightened."

2.

Pain in your arm(s), back, neck, or jaw. This type of pain is more common in
women than in men. It may confuse women who expect their pain to be focused on their
chest and left arm, not their back or jaw. The pain can be gradual or sudden, and it may
wax and wane before becoming intense. If you're asleep, it may wake you up. You
should report any "not typical or unexplained" symptoms in any part of your body above
your waist to your doctor or other health care provider, says cardiologist C. Noel Bairey

Merz, MD, director of the Barbra Streisand Women's Heart Center at Cedars-Sinai
Medical Center in Los Angeles.
3.

Stomach pain. Sometimes people mistake stomach pain that signals a heart
attack with heartburn, the flu, or a stomach ulcer. Other times, women experience
severe abdominal pressure that feels like an elephant sitting on your stomach, says
cardiologist Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for
Womens Health at NYU Langone Medical Center in New York.

4.

Shortness of breath, nausea, or lightheadedness. If you're having trouble

breathing for no apparent reason, you could be having a heart attack, especially if
you're also having one or more other symptoms. "It can feel like you have run a
marathon, but you didn't make a move," Goldberg says.

5.

Sweating. Breaking out in a nervous, cold sweat is common among women who
are having a heart attack. It will feel more like stress-related sweating than perspiration
from exercising or spending time outside in the heat. "Get it checked out" if you don't
typically sweat like that and there is no other reason for it, such as heat or hot flashes,
Bairey Merz says.

6.

Fatigue. Some women who have heart attacks feel extremely tired, even if
they've been sitting still for a while or haven't moved much. "Patients often complain of a
tiredness in the chest," Goldberg says. "They say that they can't do simple activities, like
walk to the bathroom."
Not everyone gets all of those symptoms. If you have chest discomfort, especially if you
also have one or more of the other signs, call 911 immediately.

What NOT to Do
If you feel heart attack symptoms:

Dont delay getting help. "Women generally wait longer than men before going

to the emergency room," says Rita F. Redberg, MD, MSc, FACC, director of Women's
Cardiovascular Services for the UCSF Division of Cardiology in San Francisco. Even if
you think your symptoms arent that bad or will pass, the stakes are too high.
Don't drive yourself to the hospital. You need an ambulance. If you drive, you
could have a wreck on the way and possibly hurt yourself or someone else.

Dont have a friend or relative drive you, either. You may not get there fast

enough.
Dont dismiss what you feel. "Don't worry about feeling silly if you're wrong,"
Goldberg says. You have to get it checked out right away.
"People don't want to spend hours in an emergency room if it isn't a heart attack,"
Bairey Merz says. "But women are actually good at deciding what is typical for
themselves and when to seek health care.