Heart Attack: Women attacking back
It can't happen to me, you say. I'm thin, I'm a woman, I exercise - I don't have to worry about having a heart attack. The fact is, "heart attack can be caused by factors many women may not have even considered," explains
Yelena German, MD, a cardiologist at Virtua Hospital Voorhees.
Get the facts & the tests
The difference between men & women
Change your lifestyle
Common & not-so-common signs
If you need cardiac care
The proof is in the numbers. More American women over age 50 die of heart disease than cancer. The survival rate for women is lower than for men, and the incidence of repeat heart attack is greater for women. Both survival and reoccurrence rates are higher for African American women than for Caucasian ones. And, women with diabetes are especially at risk.
Get the facts and the tests
The most common risk factors are similar for both genders — smoking, diabetes, high cholesterol, obesity, inactivity, high blood pressure or hypertension, and family history.
There are, however, distinct considerations for women. Take cholesterol, for instance, a major risk factor for heart disease that is directly related to where a woman is in the life cycle.
Cholesterol levels among women begin to rise around age 40 and continue to increase until they reach 60 something. In fact, research shows that women's cholesterol is higher than men's from age 55. For these reasons, physicians recommend that women have their cholesterol checked and benchmarked every few years from age 20. Once perimenopause begins, physicians suggest an annual lipid profile, which provides a more accurate picture of cholesterol.
The difference between men & women
Much of this has to do with estrogen, the female hormone that "protects" women from heart disease by decreasing LDL or bad cholesterol; raising HDL or good cholesterol; relaxing the blood vessels, and shielding the vascular lining from a build up of plaque. When a woman reaches menopause, estrogen levels are reduced drastically which causes bad cholesterol to spike and good cholesterol to plummet. "This is when the risk of heart attack becomes highest. And, if menopause occurs due to hysterectomy, the risk rises even more sharply," explains Mary Campagnolo, MD, chief of the Department of Family Practice at Virtua Hospital Burlington County. Studies also note that having low levels of good cholesterol can be a stronger risk factor for women than for men.
It's also known that women develop heart disease about 10 to 15 years later than men because of the estrogen factor. While this appears to be good news, the fact is that it opens the door to other problems. "Because a woman is generally older than a man when she develops heart disease, the problem is complicated by other illnesses she has probably developed during her life," says Reginald Blaber, MD, a Virtua Hospital Marlton cardiologist.
An alarming difference between men and women deals with life after heart attack. "Men are twice as likely as women to participate in cardiac rehabilitation," says Dr. Blaber. The reasons vary. Men have a wife to push them; women may be too weak or frail due to co-existing medical problems; women are more likely to be widowed and not have anyone to take them; women of that generation don't exercise. "Forty percent of women over age 60 don't exercise," says Dr. Blaber.
High blood pressure is another major risk factor, and half of all women over age 55 have it. As a woman ages, her risk for high blood pressure becomes greater than that of a man's, and the chances of developing it are increased considerably following menopause. While the reasons aren't clear, African American women are more susceptible to high blood pressure than white women, and the disease is often more serious.
For those who do have one or more risk factors for heart disease, a new test called C-Reactive Protein may be a useful tool in improving a physician's ability to predict an individuals' risk of a cardiovascular event. Virtua is one of the few health systems in the area performing it.
Change your lifestyle
Protection from heart disease requires taking matters into your own hands. See your physician for regular checkups and screenings. Stop smoking and start a regular exercise program. Just 30 minutes of moderate-intensity aerobic exercise four to six times a week, (or 15 minutes two times a day), can help you get healthier. Do anything: walk, jog, lift weights, dance, run with your dog. A Mediterranean-style diet can also contribute to better heart health because it's low in fat, de-emphasizes red meat, and dishes-out healthy servings of fish and chicken, fresh fruits and vegetables, and olive oil.
To help you along the way, Virtua Health sponsors a full range of healthy living and disease-management programs. Whether you're looking for a hypnosis class for smoking cessation or a support group for motivation, one of Virtua's Community Health Education Programs can help you take heart disease to heart.
Common and not-so-common signs
The signs of a heart attack may be milder and less apparent for women than for men. According to Dr. Blaber, symptoms may include abdominal or stomach pain; dizziness; unexplained anxiety, weakness or fatigue; palpitations, cold sweats or paleness. The universal signs are recurrent chest pain lasting more than a few minutes; pain that spreads to the neck, shoulder or arms; chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.
If you need cardiac care
From the diagnosis and management of high blood pressure to the treatment of heart attack, the cardiac care team at Virtua Health provides outstanding clinical care including evaluation, treatment and aftercare. Cardiac suites are equipped with beds that have special monitors for continuous evaluation of heart rhythms. The Cardiac Catheterization Lab at Virtua West Jersey Hospital Marlton uses state-of-the-art digital technology, which eliminates the wait time for film processing and provides faster results.
Cardiac rehabilitation programs in Marlton, Mount Holly and Voorhees provide a monitored program designed to reduce risk factors that contribute to heart disease through a personalized exercise and education plan that is developed, evaluated routinely and adjusted to reflect progress. Specialists - dietitians, exercise physiologists and nurses - teach group and individual classes. A cardiologist is on the premises in case of emergencies, as are health professionals trained in advanced cardiac life support. And, educational materials are available for independent learning.