Why is it important for women to learn about coronary artery disease?
Many women underestimate the threat coronary artery disease (CAD) poses to their health. Coronary artery disease is the number one killer of women in the United States. Yet in a recent survey, 50% of women replied that they still considered cancer their biggest health threat. Only 13% cited coronary artery disease as their biggest concern.
Health campaigns over the past decade have promoted heart disease prevention by encouraging people to lower their blood pressure and cholesterol, change their diet and exercise habits, quit smoking, and improve their medical care. However, many women are missing this message. In a study of 1,820 people hospitalized for heart attacks from 1979 to 1994, heart attack rates for men dropped by 8%, while heart attacks in women increased by 36%.
What is coronary artery disease?
Coronary artery disease is caused by the gradual buildup of plaque (made of fat, cholesterol, and other substances) on the inside walls of the coronary arteries. These arteries supply oxygen-rich blood to the heart. Over time the plaque deposits grow large enough to narrow an artery's inside channel, decreasing blood flow to the heart muscle. If the plaque becomes unstable and ruptures, a blood clot can form at the rupture site and block blood flow, resulting in a heart attack.
What factors lead to coronary artery disease and death in women?
The rate of coronary artery disease increases 2 to 3 times after menopause, the time of life when a woman's menstrual periods stop. This increase is not completely understood, but cholesterol, high blood pressure, and fat around the abdomen-all risk factors for coronary artery disease-also increase around this time.
In the past, medical research on heart disease was primarily focused on men. Now, researchers recognize that there are significant differences in coronary artery disease in women and men. For example, men usually have typical heart attack symptoms: chest pain that grips the chest and spreads to the shoulders, neck, and arms. Although women can have these symptoms too, women are more likely to have less typical symptoms such as breathlessness, heartburn, nausea, or fatigue. Heart attacks in women are often brought on by anxiety or mental stress, and even sleep, while heart attacks in men more often come on with exercise or exertion.
Because women do not always have the classic heart attack symptoms or typical onset of heart attacks, they may delay seeking care or, when seeking care, may not be treated as aggressively as men.
What can women do to prevent coronary artery disease?
In response to these concerns, the American Heart Association recently published specific guidelines for preventing and treating coronary artery disease in women. These guidelines address lifestyle changes, medications and supplements, and hormone therapy in menopausal women. Ask your doctor which recommendations are appropriate for you.
How will my doctor determine my risk for coronary artery disease?
Your doctor will calculate your risk for coronary artery disease by assessing the number of risk factors you have. Risk factors include: high LDL cholesterol level (greater than 130); cigarette smoking; high blood pressure (140/90 mm Hg or greater) or taking medication to treat high blood pressure; low HDL cholesterol (less than 40 mg/dL); family history of early coronary artery disease in father or brother before age 55; heart disease in mother or sister before age 65; and being older than 55 or having gone through early menopause.