Women and Heart Disease: How Much Do You Know?

Paul Teirstein, M.D.

Fri February 27, 2015 10:56am

It’s the leading cause of death among women and it’s not breast cancer or any other type of cancer. It’s heart disease, and it takes the life of one woman in the United States every minute, according to the American Heart Association. Yet many women worry less about heart disease than cancer—even though nearly twice as many women die from heart disease than all forms of cancer combined.
Women may underestimate their risk because of the common misconception that heart disease primarily affects men. While it is true that more men than women die from heart disease, the death rate among men has steadily declined during the past 25 years. Unfortunately, the same cannot be said for women. In fact, women age 45 and older are more likely than men to die within a year of their first heart attack, according to the American Heart Association.
So why does heart disease affect men and women differently? There are a number of reasons why heart disease affects the sexes differently, and we are learning more about them every day:
• Hormones, especially estrogen, may play a role in protecting women from heart disease since a woman’s risk for heart disease increases after menopause.
• Heart size and strength may be another factor. The right ventricle of the heart is responsible for pumping blood to the lungs to collect oxygen. If the right ventricle becomes weakened, the risk of heart problems increases. According to a study reported in Circulation: Journal of the American Heart Association, the right ventricle is smaller in women than in men, so it may be more vulnerable.
• Research also tends to overlook gender differences. Women traditionally have been underrepresented in research studies, and cardiovascular clinical trials report sex-specific results only about 25 percent of the time. As a result, it can be challenging to determine how gender may influence results.
Do women have different heart attack symptoms than men? Yes. Both men and women may feel chest pain or break out in a cold sweat during a heart attack, but that is where most of the similarities end. The differences are most evident in the symptoms leading up to the heart attack and women tend to have subtler symptoms. These may begin up to a month before a heart attack and include:
• Fatigue or weakness
• Pain, pressure, or tightness in the center of the chest
• Pain that spreads to the upper body, neck or jaw
• Unusual sweating, nausea or vomiting
• Sudden dizziness
• Shortness of breath
• Problems sleeping
Because many of these symptoms can be associated with common illnesses such as the flu, women are more likely to brush them off or assume something less serious is going on. If you experience these symptoms, don’t ignore them. Play it safe and call 911. The sooner you get treatment, the greater the chances of recovery.
Paul Teirstein, M.D., is director of the Prebys Cardiovascular Institute, opening in March on the campus of Scripps Memorial Hospital La Jolla, 9888 Genesee Ave. For more information or a physician referral, please call 1-800-SCRIPPS.