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Heart disease in women: Understand symptoms and risk factorsBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/heart-disease/HB00040
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Heart disease in women: Understand symptoms and risk factors
All women face the threat of heart disease. But becoming aware of symptoms and risks unique to women, as well as eating a heart-healthy diet and exercising, can help protect you.By Mayo Clinic staff
Although heart disease is often thought of as a problem for men, more women than men die of heart disease each year. One challenge is that the heart disease symptoms in women can be different from symptoms in men. Fortunately, women can take steps to understand their unique symptoms of heart disease and to begin to reduce their risk of heart disease.
Heart attack symptoms for women
The most common heart attack symptom in women is some type of pain, pressure or discomfort in the chest. But it's not always severe or even the most prominent symptom, particularly in women. Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:
- Neck, shoulder, upper back or abdominal discomfort
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or dizziness
- Unusual fatigue
These symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks. This may be because women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease or microvascular disease.
Many women tend to show up in emergency rooms after much heart damage has already occurred because their symptoms are not those typically associated with a heart attack. If you experience these symptoms or think you're having a heart attack, call for emergency medical help immediately. Don't drive yourself to the emergency room unless you have no other options.
Heart disease risk factors for women
Although the traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — affect women and men, other factors may play a bigger role in the development of heart disease in women. For example:
- Metabolic syndrome — a combination of fat around your abdomen, high blood pressure, high blood sugar and high triglycerides — has a greater impact on women than on men.
- Mental stress and depression affect women's hearts more than men's. Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment, so talk to your doctor if you're having symptoms of depression.
- Smoking is a greater risk factor for heart disease in women than in men.
- Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (small vessel heart disease).
Is heart disease something only older women should worry about?
No. Women under the age of 65 who have a family history of heart disease should pay particularly close attention to the heart disease risk factors. Women of all ages should take heart disease seriously.
What can women do to reduce their risk of heart disease?
There are several lifestyle changes you can make to reduce your risk of heart disease:
- Exercise 30 to 60 minutes a day on most days of the week.
- Maintain a healthy weight.
- Quit or don't start smoking.
- Eat a diet that's low in saturated fat, cholesterol and salt.
You'll also need to take prescribed medications appropriately, such as blood pressure medications, blood thinners and aspirin. And you'll need to better manage other conditions that are risk factors for heart disease, such as high blood pressure, high cholesterol and diabetes. Some women at high risk of heart disease may also benefit from the use of supplements, such as omega-3 fatty acids.
Exercise to reduce the risk of heart disease in women
In general, you should do moderate exercise, such as walking at a brisk pace, for 30 to 60 minutes most days of the week. If you can't get all of your exercise completed in one session, it's fine to break up your physical activity into several 10- to 15-minute sessions. You'll still get the same heart-health benefits.
There are other small changes you can make to increase your physical activity throughout the day. You can take the stairs instead of the elevator, walk or ride your bicycle to do errands, or try some sit-ups or push-ups while watching television.
What's a healthy weight?
What's considered a healthy weight varies from person to person, but having a normal body mass index (BMI) is helpful. This calculation helps you see if you have a healthy or unhealthy percentage of body fat. A BMI of 25 or higher can be associated with an increased risk of heart disease. Losing just 10 to 15 pounds can help by lowering your blood pressure and reducing your risk of diabetes — both of which increase your risk of heart disease.
Is the treatment for heart disease in women different than in men?
In some women, plaques build up as an evenly spread layer along artery walls, which isn't treatable using procedures such as angioplasty and stenting designed to flatten the bulky, irregular plaques in some men's arteries. For some women, drug treatment — rather than angioplasty or stenting — may be a better option.
Certain heart medications, such as clot-busting drugs (thrombolytics) tend to be more effective in women than in men. Aspirin therapy benefits both men and women, but there's also a difference between men and women in the effects of aspirin therapy. In women, aspirin therapy seems to reduce the risk of stroke more than in men, while in men it reduces the risk of heart attack more than it reduces stroke.
Taking aspirin to prevent heart disease in women
Guidelines from the American Heart Association urge women to be more aggressive about cutting their heart disease and stroke risks. A daily aspirin can have a number of benefits for women, such as preventing heart attacks and strokes and reducing heart disease risk.
The guidelines recommend that women consider taking aspirin — which means have a discussion with your doctor about the risks and benefits of taking aspirin based on your own individual stroke and heart attack risk. Don't start taking aspirin for heart disease prevention on your own. The higher your risk of heart attack or stroke, the more that risk is reduced by taking aspirin, but the higher your risk is of bleeding.
- Mosca L, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007;49:1230.
- Douglas PS, et al. Determinants and management of cardiovascular risk in women. http://www.uptodate.com/home/index.html. Accessed Oct. 21, 2010.
- Lloyd-Jones D, et al. Heart disease and stroke statistics: 2009 update. Circulation. 2009;119:e21.
- Frequently asked questions: Heart disease. U.S. Department of Health and Human Services. http://www.womenshealth.gov/faq/heart-disease.pdf. Accessed Oct. 20, 2010.
- Douglas PS. Management of coronary heart disease in women. http://www.uptodate.com/home/index.html. Accessed Oct. 21, 2010.
- Douglas PS. Clinical features and diagnosis of coronary heart disease in women. http://www.uptodate.com/home/index.html. Accessed Oct. 21, 2010.
- U.S. Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine. 2009;150:396.