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Heart Disease Looks Different In Women

According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death for women in the United States, killing 289,758 women in 2013—about a quarter of all female deaths. And although heart disease is often thought of as a “man’s disease,” it kills approximately the same number of women and men each year.

Because February is American Heart Month, our family practice doctors in Delray Beach, Florida, want to highlight the risks, warning signs, and preventive measures you can take in combating this deadly disease.

Differences in women

Although men and women die at the same rate from cardiovascular disease (CVD), there are some notable differences between the two.

1. The symptoms may be different

Although chest pain or pressure is the most common sign of a heart attack in both sexes, some women may not experience that symptom at all; but other symptoms may signal a heart attack in women, such as:

• neck, jaw, shoulder, upper back, or abdominal pain
• shortness of breath
• pain in one or both arms
• nausea or vomiting
• sweating
• lightheadedness or dizziness
• unusual fatigue

In addition, women more often tend to experience heart-attack symptoms when they’re resting or even sleeping, as opposed to men, whose symptoms may manifest more often with exertion.

2. Pregnancy and breast cancer offer unique risks

Peripartum cardiomyopathy (a weakness of the heart muscle) is a cause of heart failure unique to women. Though rare, it can occur during the final month of pregnancy or after delivery. Experiencing high blood pressure (preeclampsia) or gestational diabetes (present only during pregnancy) may also put women at future risk of CVD in the future.

And women with breast cancer who have been treated with chemotherapy seem to be more at risk for CVD due to the drugs’ toxic effect on the heart muscle.

3. Women are more susceptible to broken-heart syndrome

Mental stress is more likely to trigger a heart attack in women. Grief is especially stressful on the heart muscle, and has been known to trigger stress-induced cardiomyopathy. The most famous recent example what when actress Debbie Reynolds suffered a fatal stroke one day after her daughter Carrie Fisher died from a heart attack.

What happens in the stress-induced attack is an abrupt swelling of the left ventricle, brought on by the sudden release of large amounts of dopamine, adrenaline and norepinephrine. This can cause the heart to malfunction, and even create blood clots which—as is thought to have happened to Reynolds—can then travel to the brain and cause a stroke.

Although “broken-heart syndrome” can often mimic the symptoms of a heart attack, it doesn’t normally kill so quickly. Rather, the long-term effects of grief can cause damage to the heart and blood vessels, eventually resulting in CVD.

Risk factors

According to the CDC, the risk factors for CVD include high blood pressure (a reading above 130/80) high LDL cholesterol, and smoking. High blood pressure is especially insidious because it usually produces no symptoms.

Ivor J. Benjamin, MD, volunteer president of the American Heart Association (AHA) and director of the Cardiovascular Center at the Medical College of Wisconsin in Milwaukee, recently noted, “Research has shown that eliminating high blood pressure could have a larger impact on CVD deaths than elimination of all other risk factors among women.”

Other medical conditions and lifestyle choices can also put people at higher risk for heart disease, the CDC says. These include:

• diabetes
• overweight and obesity
• poor diet
• physical inactivity
• excessive alcohol use

Prevention

The good news is that 80 percent of deaths from heart disease can be prevented, according to the AHA.

To reduce your chances of getting heart disease, the CDC recommends the following:

1. Know your blood pressure, and have it checked regularly.
2. Get screened for diabetes. Having uncontrolled diabetes raises your chances of CVD.
3. Quit smoking.
4. Have your cholesterol and triglyceride levels checked regularly.
5. Make healthy food choices, including fresh fruits and vegetables, oatmeal, nuts and seeds, and salmon and other fatty fish, such as sardines and mackerel. Restrict processed foods.
6. Limit alcohol intake to one drink a day.
7. Lower your stress level and find healthy ways to cope with stress.

We are more than happy to discuss all these factors with you, explain what each means, and how you can use that knowledge to improve your heart health.