Diabetes Forecast

A Woman's Disease

By Shauna S. Roberts, PHD , , ,

Seventy times a minute, 100,000 times a day, 35 million times a year, your heart beats, pumping blood through 60,000 miles of blood vessels to deliver precious oxygen to all your cells. Over an average lifetime, a heart pumps 1 million barrels of blood. But modern sedentary lifestyles and high-fat, high-calorie diets have made it harder on our tickers. Heart disease is now the leading cause of death in America. Until recently, heart disease was once viewed as a male problem, and research focused on men. But we now know that more women than men die each year of heart and blood vessel disease. One in three adult women has some form of cardiovascular disease. And recent research has revealed that heart disease differs in crucial ways between men and women.

How We're Different

  • American women are older when they have their first heart attack—an average of 70.4 years old, versus 65.8 for men.
  • Women often have different heart attack symptoms than men. They are less likely to have traditional symptoms such as chest pain.
  • Women are more likely to die soon after having a heart attack.
  • Two-thirds of women—but only half of men—who die suddenly of heart disease had no symptoms beforehand.
  • Women are more likely to have silent heart attacks. In one study, more than half of women's heart attacks (versus a third of men's) were diagnosed only when an electrocardiogram (EKG) revealed unsuspected heart damage. Silent heart attacks are also more common in people with diabetes.
  • Treadmill exercise tests are less accurate at diagnosing blocked arteries in women.
  • Among people who've had one heart attack, women are twiceas likely as men to have another heart attack or to be disabled with heart failure within 6 years.
  • Men's risk of heart disease rises gradually as they age. But when women go through menopause, their risk of heart disease suddenly doubles or triples.
  • Having diabetes raises a woman's risk of dying of heart disease much more than it raises a man's.
  • Men who have ischemia (reduced blood flow to the heart) typically have plaque blocking a large heart artery. But in women, ischemia more often results because many small arteries are lined with plaque or because their blood vessels are stiffer and have spasms. Treatment is thus more difficult in women because doctors can't just open up or replace one or two big vessels.

Symptoms To Watch For:

● Chest pain or discomfort (such as pressure, squeezing, crushing, or heaviness)
● Pain or soreness in the back, neck, jaw, arm, or stomach
● Shortness of breath
● Sweating
● Tiredness
● Lightheadedness
● Nausea or vomiting
● Weakness
● Anxiety

Symptoms of heart attack can vary from person to person and from one heart attack to the next in the same individual. Symptoms may be mild or severe. They may be constant, or they may come and go. Women are more likely than men to have symptoms other than chest pain.

How We're The Same

Nine risk factors play major roles in heart attacks in both men and women: smoking cigarettes, unhealthy blood lipid levels (such as cholesterol), high blood pressure, diabetes, obesity in the abdomen, lack of exercise, low intake of fruits and vegetables, high intake of alcohol, and "psychosocial factors" (such as stress at work or financial problems).

However, statistics show that some risk factors are more dangerous for women, including high triglyceride levels and diabetes. Also, traditional risk factors do not predict heart disease in women as accurately as in men, suggesting other factors are at work in women.

In An Emergency

If you think you may be having a heart attack, chew a regular aspirin (325 milligrams) right away. Doing so may reduce heart damage.

Next, call 911 right away. It's better to wait for an ambulance than to have a friend or relative drive you to the hospital; emergency personnel can start treatment in the ambulance. Don't endanger yourself or others by getting behind the wheel.

Some people wait to see whether their symptoms go away. They don't want to waste the doctors' time or be embarrassed if their pain turns out to be something minor. But heart attacks need immediate attention. It's better to go to the hospital for a false alarm than to wait and end up with more severe damage.

At the hospital, make sure that you are given tests (such as blood tests and an EKG) to find out whether you have had a heart attack, even if you are young or you are a woman. Remember, people with diabetes get heart disease younger than other people do.

Shauna S. Roberts, PhD, is a science writer in Riverside, Calif.



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