Women and Heart Disease

Marisol, a 42-year-old Hispanic woman, had always enjoyed good health. She had high blood cholesterol, but it never caused her any problems. She awoke one morning unusually fatigued. She was short of breath, but she attributed that to being out of shape and inactive. She made an appointment with her dentist when she noticed severe jaw pain, thinking she might have an abscessed tooth. Her dentist found nothing wrong and sent her on her way.

Janet, 72, was a lifelong smoker. Her two-pack-a-day habit had caused her high blood pressure problems, but it was something she enjoyed. At her age, she was not about to give it up. She had given up her driver's license several years earlier and was no longer able to live an active life. She often felt stressed and depressed. She blamed her sudden heartburn and indigestion on her high blood pressure, took a few antacids, and went back to bed.

Aubrey was a 58-year-old African American. She had battled her weight all her life, but she was still morbidly obese. She had adult-onset diabetes and lived a very sedentary lifestyle. She awoke one day with an ominous feeling that something was terribly wrong. She felt cold and clammy, struggled for breath, and was extremely nauseated. Her home health aide suggested that she simply rest, and she happily obliged.

Marisol misunderstood her symptoms. Janet's age and smoking put her in a high-risk category. Aubrey's race, obesity, and diabetes left her in a lethal situation. All three women ultimately succumbed to the number-one killer of women. Unfortunately, they did not have to die that way. Heart disease kills more women than men annually, butthere are things every woman can do to reduce her risk of death.

The term "heart disease" refers to any disorder or disease related to the heart, including heart attacks and strokes. Most women fear breast and other cancers, but in reality, six times more women die of heart disease than cancer. Eight million American women are living with heart disease. A Center for Disease Control survey in 1994 found that eighty percent of American adults have at least one risk factor for heart disease. Most risk factors for heart disease are directly related to lifestyle habits. Nearly all of them can be reduced or eliminated by simply changing habits and routines. (Faust).

Women who smoke tend to have their first heart attack nineteen years earlier than women who do not smoke. Women who have diabetes are two to three times more likely to have a heart attack than women who do not have diabetes. Lack of exercise, high blood pressure, high blood cholesterol, and obesity are all preventable or treatable risk factors for heart disease as well. (womenheart.org).

"Women of color, especially black women, are at increased risk of heart attacks" (Faust 6). Age is also an uncontrollable risk factor. Once a woman reaches menopause, her risk rises dramatically. A family history of heart disease also puts a woman's risk higher than average. A woman cannot change her race, her age, or her family history, but her awareness of these risk factors can help her minimize any other risk factors she may have. "The more risk factors you have, the greater your risk of heart disease ... the sooner you start to control your risk factors, the healthier you will be the rest of your life" (Goldberg 76).

Physical inactivity may well be the easiest factor to correct for many women. Regular aerobic exercise will strengthen the heart and lungs and help them become more efficient. It may also help prevent blood clots, ward off heart attacks, and help keep arteries healthy and clear of blockages. It is very important to reach a target heart rate, where conditioning actually happens. The easiest way for a beginner to determine this point is by exercising to the point that it is uncomfortable, but not impossible, to hold a conversation. It takes only thirty to sixty minutes of aerobic exercise most days of the week to build a stronger heart. Women often do not take time for themselves. Exercise can be the perfect way for a woman to relax and regroup from the stresses of her day, while supporting her health at the same time. (Faust).

High blood pressure may be an inherited risk factor or one caused by lifestyle. It means that the heart has a heavier workload, and it can scar blood vessel walls. It is often called "the silent killer," because it often has no symptoms until it is dangerously high. Blood pressure checks should be a part of every woman's annual checkup. To lower an already-high blood pressure, lifestyle changes are suggested prior to medication. Reducing alcohol consumption; limiting salt in the diet; losing weight; and increasing consumption of calcium, magnesium, and potassium may help. If, after six months of lifestyle changes, blood pressure remains high, medication may be suggested. It is important to note that once again, ethnicity may raise the level of risk. African American women have twice the risk of having high blood pressure that Caucasian women do. (Faust).

High blood cholesterol may also be inherited or caused by lifestyle factors. There are three different types of cholesterol that a woman's doctor needs to measure. Low-density lipoprotein, or LDL, levels should be kept beneath 160 mg/dl. High-density lipoprotein, or HDL, is known as the good cholesterol, and levels should be above 60 mg/dl. Triglycerides are a form of protein made in the body, and levels should be kept beneath 100 mg/dl. Total blood cholesterol (the sum of all three forms) should be under 200 mg/dl. Eating a healthy diet and getting regular exercise are probably the easiest ways to control cholesterol. Eliminating fatty or fried foods, avoiding trans fats, and increasing the consumption of whole grains may all help. Garlic, oat bran, psyllium fiber, and beans have also been shown to help in the reduction of cholesterol levels. If lifestyle changes do not help, medications may reduce blood cholesterol levels as well. (Faust).

Even after all controllable risk factors have been taken into account and treated, a woman may still be at risk of having a heart attack. For this reason, she absolutely must be aware of the symptoms of a heart attack in order to get appropriate medical help as quickly as possible. "From 50 to 80 percent of deaths occur within four hours after the onset of symptoms" (Ojeda 17).

Women tend to have different heart attack symptoms than men, although chest pain is present in nearly ninety percent of women. Chest pressure, strange sensations in the abdominal region, pain or pressure on the left side of the body, jaw pain, clammy sensations, shortness of breath, edema (swelling), fatigue, and nausea can also signal the onset of a heart attack in a woman. (Cool 130).

If a woman suspects she is having a heart attack, she needs to act immediately. 911 should be her first call, and she needs to tell the operator she believes she is having a heart attack. She cannot be too emphatic. Telling the operator that she is nauseated or uncomfortable or swollen may reduce the odds of her being correctly diagnosed. Doctors often dismiss women's heart attack symptoms as being psychological, further delaying proper diagnosis and treatment. Following that phone call, she should take an aspirin, unless there are contraindications (aspirin allergy or being on other blood thinners). (Cool).

"Deaths from heart attack among black women ages 35-74 are twice those of white women, and three times greater for women of other races; the rate among Native American women is five times that of white women" (Faust 6). For this reason, women of color need to be even more forceful when it comes to being treated. They should insist on having the appropriate tests done, regardless of whether the doctor attempts to dismiss their symptoms. All women should know their options and not be afraid to insist on proper treatment. Thirty-eight percent of women die within one year of having a first heart attack, compared with just twenty-five percent of men. Women are twice as likely to die after bypass surgery, and they are less likely to receive beta-blockers or aspirin therapy. (womenheart.org).

Marisol could have reduced her risks by exercising and reducing her high blood cholesterol. Simply by exercising more, she could have reduced her risk as much as forty-five percent. Janet could not change her age, but she could have attempted to quit smoking and made some healthy lifestyle changes to lower her blood pressure. Quitting smoking could have lowered her risk as much as fifty to seventy percent. Aubrey could not change her race, but she may have been able to lose some weight through diet and exercise combined. She could also have better managed her diabetes. Losing the excess weight could have reduced her heart attack risk by thirty-five to fifty percent. Had any of these women been aware that their symptoms were classic symptoms of a female heart attack, they may have been able to save their lives by taking an aspirin and getting immediate medical assistance. (Faust).

Making drastic lifestyle changes is rarely easy, but lowering all controllable risk factors will go a long way towards catching problems early. Women need to insist on having their cholesterol and blood pressure checked annually. They may need to enlist the aid of their doctor or nutritionist to stop smoking or lose weight. Their families and friends may need to become their cheerleaders in their efforts to become fit and healthy. Knowing the symptoms of a heart attack and knowing exactly what to do during what is inarguably a very frightening situation may mean the difference between survival and death.

Works Cited

Baron-Faust, Rita. Preventing Heart Disease: What Every Woman Should Know. New York: Hearst Books, 1995.

Goldberg, Nieca. Women are Not Small Men. 1st ed. New York: Balantine Books, 2002.

Lisa, Cool C. "Would You Know If You Were Having a Heart Attack?" Ladies' Home Journal Feb. 2008: 128-136.

Ojeda, Linda. Her Healthy Heart. Alameda: Hunter House, 1998.

"Women and Heart Disease Fact Sheet." Womenheart.Org. Feb. 2008. Women Heart. 26 Jan. 2008 .