Although heart disease has long been the leading cause of death, both in the U.S. and worldwide, a Harris poll conducted on behalf of the American Heart Association (AHA) found that 51% of respondents were unaware of that fact. It is no surprise then that the AHA and healthcare providers continue to push education about the deadly disease each year during February, known as “American Heart Month.”
In the past, men have been more likely to be diagnosed with heart disease than women. Although there is more ongoing research to explore women’s risks of the condition, it was not until 1999 that the AHA and American College of Cardiology issued the first clinical report on preventing of heart disease in women. This lag is now mitigated by robust research with gender-specific studies
Men and women present with heart disease in mostly similar manners, but the how’s and why’s differ. One major factor in this disparity is the presence of female hormones, particularly estrogen. Pre-menopausal women are less likely to develop heart disease, as estrogen increases the “good” cholesterol (HDL) so that the “bad” (LDL) cholesterol is proportionally lower. This helps to reduce plaque buildup and inflammation in the arteries, common causes of developing of heart disease.
Women in general have smaller bodies than men, with smaller internal organs, including hearts, and vascular structures so effects of medications and outcomes of procedures can differ from those of men. In addition, as all people age, hypertension (high blood pressure) becomes more prevalent, as aging arteries become less flexible and less resilient, negatively affecting blood flow. Weight gain can also occur as we age, as metabolism slows down and activity levels decline. Obesity can also lead to sleep apnea, a condition that remains underdiagnosed for both genders.
Like men, women present with the following symptoms:
- Chest pain or tightness (angina)
- Pain in the neck, shoulder, arm, or back
- Shortness of breath
- Fatigue
- Nausea (less common in men)
- Abdominal discomfort (less common in men)
Unfortunately, women often underreport these symptoms. Most women are caregivers and tend to place others’ needs ahead of their own, often minimizing their symptoms which may delay much-needed medical attention.
Women are also more likely to develop broken-heart syndrome (Takotsubo cardiomyopathy), where an intensely stressful event occurs and can result in a weakening of the heart muscle. Fortunately, this is often a reversible condition.
I highly recommend anyone experiencing such symptoms to see their physician as soon as possible or, if the symptoms are severe, to go to their local emergency department.
One can never be “too cautious” when it comes to heart health. I recently saw an older retiree who had suffered from chest pain for two weeks before seeking medical advice; she had been taking care of an ill family member. Unfortunately, she had developed congestive heart failure from a massive heart attack that was not treated in a timely fashion.
You may be surprised to learn that you can have a heart attack and not necessarily know it; these are called “silent heart attacks” and can be brought on by the same factors that cause symptomatic heart attacks:
- Diabetes
- Excess weight
- Family history of heart disease
- High blood pressure
- High cholesterol
- Lack of exercise
- Tobacco use
Although doctors are always recommending giving up using tobacco, I want to emphasize that smoking can have profoundly negative effects on your heart and blood vessels. A recent study showed that women aged 18-49 who smoke are 13 times more likely than their non-smoking contemporaries (men in the same age group who smoke are 9 times more likely to suffer the same fate). In addition, those who have vaped are 19% more likely to develop heart failure than those who have never done it before.
As you can see, a delay in diagnosis can result in a delay in proper medical care, which in turn can result in a heart attack or stroke – with the attendant life-altering effects. Many of the seemingly insignificant symptoms can be a sign of serious illness. Do not become a statistic; learn about your risk for heart disease and how you can proactively address it.
Dr. Jeannette Yuen is a Cardiologist with Scarsdale Medical Group, seeing patients at the Harrison location. To make an appointment, please call 914-723-8100.