Heart disease:
A woman's greatest health threat

True or false? More women die each year of heart disease than breast, cervical and ovarian cancers combined.

If you answered “true,” you're correct: Almost 250,000 American women die from coronary heart disease (CHD) each year. Yet, most women still think of cancer as the greatest threat to their health. Furthermore, many women believe that heart disease is exclusively a man's disease.

These beliefs are dangerous myths. Since many women think that CHD will not affect them, they tend to downplay symptoms and underestimate their severity. This way of thinking may be due in part to a lack of adequate information tailored to females about CHD. (On the research side, women participants make up only one-quarter of all heart-related studies.)

The differences between the sexes
CHD affects women differently than it does men. It tends to occur in women about 10 years later than in men. Women are also usually about 20 years older than men are when they experience more serious cardiac events such as heart attack.

Why the differences? One reason is that women have built-in hormone protection in their premenopausal years: Estrogen helps shield women from heart disease by helping to raise good cholesterol levels and lower bad levels. Once a woman reaches menopause, her estrogen levels drop and her CHD risk rises.

Women don't always suffer from the same heart attack symptoms as males and so may deny they're having a heart attack. Women take longer—about a half-hour longer—to seek help at an emergency room. Consequently, they are also less likely than men to be admitted to the hospital for evaluation of coronary artery disease and tend to be underdiagnosed.

While women may be aware of the classic signs of an attack, they aren't aware of symptoms they are more likely to experience. In fact, one-third of women experience the following symptoms often with no chest pain at all:

• sudden onset of severe weakness
• stomach upset or nausea with passing weakness
• mild burning sensation in the middle of the chest that extends outward
• vague chest discomfort
• palpitations, cold sweats or paleness

What's a woman to do?
Simple lifestyle changes can dramatically reduce their risk of CHD. Both women and men can improve their heart health by getting back to tried-and-true basics:

• Don't smoke. Women who smoke risk having a heart attack 19 years earlier than nonsmokers.
• Maintain a healthy body weight.
• Eat a low-fat, low-cholesterol diet and limit your salt intake.
• If your cholesterol is high, lower it.
• Control high blood pressure.
• Keep diabetes under control. Women with diabetes are two to three times more likely to have heart attacks.
• Limit your alcohol use.
• Exercise regularly.

Heart disease symptoms to look out for
Spotting heart disease symptoms can prevent an attack and save your life. Warning signs include:

• chest pain—known as angina—ranging from mild to severe
• shortness of breath
• extreme fatigue
• swelling in your feet or ankles
• palpitations
• a feeling of heaviness, pain, tightness, burning or pressure behind your breastbone or in your arms, neck or jaw