World Heart Day – September 29

World Heart Day - September 29th

Women & Cardiovascular Health

Coronary heart disease (CHD) is the leading cause of death in American women, with about 1 of every 4 female deaths directly attributed to the disease each year, according to the Centers for Disease Control (CDC.) About 80% of women between age 40 to 60 have one or more risk factor for coronary heart disease, with many not aware of their personal cardiovascular health risks. Almost 1 in 16 U.S. women age 20+ years, or 6.2%, have coronary heart disease, the most common form of heart disease. Yet despite increased awareness over the past decades, only about 56% of U.S. women recognize heart disease as their greatest health foe.

World Heart Day is designated September 29, offering a perfect opportunity to reflect on your personal heart health. Your local Capital Women’s Care team wants to empower you with important tips on how to optimize your cardiovascular health; recognize cardiovascular disease risk factors and symptoms and understand when to see your doctor. Our team wants to teach you how to implement heart healthy practices within your personal care plan so you can enjoy a long, quality life.

Unique Heart Issues

There are several gender disparities regarding women and men’s heart health. Heart attack symptoms usually present differently in men and women, which can attribute to its undertreatment in women and delay women’s diagnosis and treatment. Additionally, women are more likely to experience long-term complications after a heart attack than men. Women are more likely than men to have a second heart attack within 1 year. Most importantly, women face greater risk of heart failure (HF) than men, even after one heart attack.

Researchers recognize female-pattern cardiovascular diseases need further investigation and study to bridge these gender disparities and are making progress in this arena. Most cardiovascular health studies have primarily been male-dominant and focused; however, current such studies indicate an encouraging 30% women participation.

Women’s cardiovascular physiology also presents unique health concerns. A woman’s heart is 2/3 the size of a man’s heart, which in turn means the heart works harder to circulate blood. During pregnancy, female cardiovascular systems work even harder.  Additionally, artery diameters within females are smaller, creating greater likelihood of arterial blockages (arteriosclerosis), which lead to heart attack, stroke and peripheral arterial disease (PAD.)

According to researchers, women also need to expand awareness and knowledge of heart disease prevention. Therefore, it’s vital to recognize your cardiovascular risk factors and understand symptoms relating to cardiovascular issues to get swift appropriate treatment and avoid permanent damage to your heart and overall health.

Cardiovascular Risk Factors

There are several risk factors that increase a woman’s heart disease risk. Women with the following have increased heart disease risk:

  • Family history. Like men, women can be impacted by family history of heart disease, particularly when a father or brother was diagnosed with coronary artery disease (CAD) before age 55 or a mother or sister was diagnosed before age 65.
  • Age. Women of all ages should take heart disease seriously. Women under the age of 65, and especially those with a family history of heart disease, need to pay close attention to heart disease risk factors. Women who have gone through menopause are at increased heart disease risk due to hormone changes. Menopause also is a time when weight gain is likely, causing unhealthy numbers in your cholesterol and blood pressure which increase heart disease risk.
  • Heritage. Certain minority groups face a greater heart disease risk than others. These differences appear to stem from increased prevalence of high blood pressure, diabetes and obesity seen in some populations.
  • Some common health problems are linked to increased heart disease risk. Diabetes, high blood pressure, inflammatory arthritis, lupus, and high cholesterol can increase your risk of heart disease. New research indicates a strong link between osteoporosis diagnosis and increased cardiovascular health risk in women. Some chemotherapy or radiation treatments for cancer may also increase vulnerability to heart disease.
  • Tobacco use. Smoking is a leading cause of cardiovascular disease. If you don’t smoke, don’t start and if you do, make the effort to kick the tobacco habit for good.
  • Alcohol intake. Greater alcohol consumption (more than 1 alcoholic beverage/day for women) signifies proven increased heart disease risk for women.
  • Having certain women-specific health issues. If you have diabetes that develops during pregnancy, gestational diabetes or hypertensive disease of pregnancy, such as gestational hypertension or preeclampsia, your risk for heart problems is much greater later in your life. Certain diseases found only in women also increase the risk of CAD, including endometriosis, and polycystic ovary disease (PCOS.)
  • Not checking or knowing your key health numbers. Blood pressure, cholesterol and blood sugar levels all contribute to identifying the state of your cardiovascular health. Make sure you have them checked regularly with your practitioner. If you require medications or treatment to stabilize them, be sure to follow your practitioner’s directions.
  • Poor sleep habits. Research indicates getting less than 6 or 7 hours of sleep nightly is connected to heart disease. Poor sleep has been linked to high blood pressure, can cause difficulty to lose weight and may decrease likelihood of exercise.
  • Sedentary lifestyle. Women lacking physical activity and exercise are more prone to heart health issues deriving from arteriosclerosis, including heart attack, stroke and peripheral artery disease (PAD.)
  • Unhealthy diet. Good nutrition bolsters heart health. Avoid foods packed with trans or saturated fats, salt/sodium, refined sugars, and those that are highly processed or fried, which add excessive fat and too many calories.
  • Being overweight or obese. Additional pounds not only tax the heart but also increase risk of developing plaque, or fatty deposits, within the arteries’ walls. This greatly increases your cardiovascular health risks, including heart attack and stroke.
  • Having high stress levels. Chronic stress within women’s lives can lead to behaviors and factors that impact heart disease, such as high blood pressure, high cholesterol, inactivity, and overeating. Counseling is a great tool not only for your mind, but also for your heart, as it helps you manage and control stress.

Identifying your risk factors and adjusting those within your control to minimize your heart disease risk plays an integral role in following a heart healthy personal care plan.

Tips for a Healthy Heart

Fortunately, there are many heart disease risk factors within our control. To optimize your heart health, you need to:

Get (and keep) moving. For the most health benefits, you need to get enough aerobic activity to get your heart pumping and do muscle-strengthening activities every week. (Always check with your doctor before starting any regular exercise you are not used to doing.)

You should get at least 30 minutes a day of moderate-intensity aerobic activity, like brisk walking, on most days of the week. The 30 minutes of heart-pumping activity don't have to be all at one time. You can break it up into 10-minute activities throughout the day.

Do the following each week:

Aerobic activity:

2 hours and 30 minutes of moderate-intensity aerobic physical activity, such as a brisk walk, OR

1 hour and 15 minutes of vigorous-intensity aerobic physical activity, such as running, OR

A combination of moderate and vigorous-intensity aerobic physical activity.

Muscle-strengthening activity:

Muscle-strengthening activities on 2 or more days.

Eat a healthy diet. Making unhealthy food choices can lead to weight gain. But that is not the only risk. Unhealthy eating affects your arteries, blood pressure, glucose level, and many other parts of heart health. Talk to your doctor or nurse about a heart-healthy eating plan that lowers your risk of heart attack and stroke. Investigate heart healthy diet choices here.

Strive to maintain a healthy weight. Reaching and staying at a healthy weight will lower your risk of heart disease and stroke. If you already have heart disease, a healthy weight will help you control your disease and prevent heart attack. A slow and steady weight loss is the best way to lose weight and keep it off. Talk to your doctor about how much weight you need to lose and the best ways to do it.

Know your heart disease numbers. Have your doctor regularly check and monitor your blood pressure, cholesterol (total, HDL, LDL, and triglycerides) and blood sugar levels. These tests will give you important information about your heart health. Your doctor can tell you what your numbers mean and what you need to do to protect your heart.

Be alert to unusual symptoms. All women need to know the symptoms of heart attack and stroke and what to do. Make sure your friends and loved ones know how to recognize the symptoms too.

If you think you are having a heart attack or stroke, call 911.

Knowing the symptoms and getting help quickly can help you survive a heart attack or stroke and make a full recovery.

Don’t smoke. If you smoke, get the help you need to quit. Start by visiting Women.Smokefree.gov for woman-specific information, tips, and tools.

Limit alcohol intake. If you drink alcohol, do so in moderation. For women, this means no more than one drink per day.

"One drink" is defined as:

a glass of wine (5 ounces)

a can of beer (12 ounces)

or a shot of liquor (1.5 ounces of 80-proof liquor)

If you don't already drink, for health reasons, don't start. Moderate drinking is also linked to breast cancer, violence, and injuries. No amount of alcohol is safe during pregnancy.

Take good care of yourself. Stress, anxiety, depression, and lack of sleep can raise your risk for heart disease. Take care of yourself with these steps:

  • Get enough sleep. Most adults need seven to nine hours of sleep each night.
  • Don't stress. Keep stress in check by taking time each day to relax and unwind.
  • Treat mental health problems. Get help if you have trouble coping because of depression, anxiety, or another health problem.
  • Make annual well-woman visits. Make an appointment with your doctor for an annual well-woman visit.

Heart Attack Symptoms

Heart attack can present differently in women than it does in men. Women often ignore danger signs of heart attack, which include:

  • heavy ache in chest or back between the shoulder blades
  • sharp pain in upper body
  • shortness of breath
  • breaking out in a cold sweat
  • unusual or unexplained tiredness
  • feeling dizzy or light-headed
  • and/or feeling sick to your stomach.

While the most common symptom for both women and men is chest discomfort, you can have a heart attack without experiencing chest pain or pressure. Women are more likely to have other symptoms such as back pain, jaw pain, shortness of breath, indigestion and nausea or vomiting.

Women are more likely than men to have heart attacks that don’t show obvious symptoms, known as silent heart attacks.

Sometimes heart disease may be “silent” and not diagnosed until you experience other symptoms or emergencies, including:

  • Heart attack: Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath
  • Arrhythmia: chest palpitations
  • Heart failure: Shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen or neck veins

If you experience any of the above, call 911 immediately.

Cardiovascular Diseases Common in Women

Some heart-related diseases and problems occur more often in women than in men. Heart problems that are more likely to occur in women include:

Chest pain and discomfort (angina.) About 4 million U.S. women suffer from angina.

Angina also affects men, but women are more likely than men to experience these specific angina types:

Stable angina. This is the most common type of angina. Women with stable angina may experience chest pain during physical activity or times of stress. The chest pain usually goes away with rest. However, it can develop into unstable angina, the type of angina which happens most often during rest or sleep. Unstable angina can lead to a heart attack or cardiac arrest.

Variant (Prinzmetal's) angina. This type of unstable angina is rare and is caused by a spasm occurring in the coronary arteries, which carry blood to the heart muscle.

Prinzmetal’s angina is rare, representing about two out of 100 cases of angina, and usually occurs in younger patients than those who have other kinds of angina.

Triggers for the spasm can include exposure to cold weather, stress, smoking or cocaine use. The spasms can lead to painful attacks, often during rest or sleep.

This type of unstable angina rarely causes a heart attack and can be treated with medication.

Cardiac syndrome X. Cardiac syndrome X occurs when those with healthy, unblocked arteries have chest pain (angina) and coronary artery spasms, resulting in the artery pinching itself closed.

The cause of cardiac syndrome X is not known. Some possible causes include:

Coronary microvascular disease (MVD). In some women, cardiac syndrome X may be caused by MVD, a disease within tiny arteries located near the heart. These arteries are too small to see on an angiogram, a diagnostic test that takes X-ray pictures of the arteries.

Women with cardiac syndrome X caused by MVD are often younger than 50 years of age and face a higher heart attack risk.

MVD affects about half of women with cardiac syndrome X.

Diagnosis occurs through physical exam and subsequent medical tests. Relieving pain is one of the main goals of treating MVD.

Treatments also are used to control risk factors and other symptoms. Treatments may include medications to improve cholesterol levels, lower blood pressure, decrease the heart's work or help prevent blood clots or control inflammation, relax blood vessels, improve blood flow to the heart and treat chest pain.

Hormonal changes. Changes in estrogen levels after menopause could make women more likely to have heart problems. Most women with cardiac syndrome X are postmenopausal or are going through menopause.

Broken heart syndrome. Broken heart syndrome, also known as stress-induced cardiomyopathy (or takotsubo cardiomyopathy), can happen even in those who are healthy.

Researchers don’t yet know its exact cause. Symptoms are often triggered by extreme stress, like intense grief, anger or surprise.

Women are more likely than men to experience broken heart syndrome. Experts think a stress hormones surge "stuns" the heart, causing intense, short-lived symptoms which usually don't result in permanent heart damage.

Most women who experience broken heart syndrome are older, between 58 and 75 years old. The syndrome is most likely due to estrogen levels dropping after menopause.

Broken heart syndrome can be misdiagnosed as a heart attack. The symptoms and test results are similar, but there are no blocked heart arteries. Instead, a part of the heart temporarily enlarges while the remainder heart area works normally.

Broken heart syndrome can lead to short-term heart failure, yet it’s usually easily treatable. Because broken heart syndrome often mimics the signs and symptoms of a heart attack, a coronary angiogram is often done to rule out heart attack. Those with broken heart syndrome often don't have any blockages in the blood vessels, while those who have had a heart attack usually have blockage clearly visible on an angiogram.

Treatment includes hospitalization and medications to reduce heart workload. Recovery usually occurs within a month, with follow up echocardiogram to monitor and evaluate heart health.

Monitoring Your Heart Health

It’s important to see your doctor before you have heart health issues to determine your heart disease risk and how you can take appropriate measures to reduce risks to your cardiovascular health. Regular blood tests can monitor heart health and alert you and your doctor to identify, address and treat concerns promptly.

If you do have symptoms, it’s important to see your doctor as soon as possible so they can test you for heart disease and provide treatment before permanent heart damage occurs.

Your local Capital Women’s Care team offers you and your family professional healthcare expertise you can trust, ensuring you and your family enjoy optimal health and longevity of life.

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