Women and Heart Disease

Cardiovascular Disease (CVD) is the leading cause of death in the United States. Every 33 seconds, an American life is claimed by heart disease. Annually, nearly 1 million Americans will die from heart disease, according to the American Heart Association. That's more lives than the next 7 causes of death combined. CVD claimed 39.4 percent of all deaths or 1 of every 2.5 deaths in the United States in 2000.

But heart disease does not just develop overnight in men or women. It is a disease that takes years to develop, according to researchers. Changes in the body that eventually lead to heart disease begin in childhood and progress slowly as people age. High blood cholesterol levels, one of the easiest risk factors to measure, clearly play a role in the development of heart disease.

Although they largely are not aware of it, women are affected by heart disease more than men, even though it strikes females 10 years later in life.

American Medical Women's Association: Educating Women about Heart Disease

The "Women's Heart Health Initiative" is an American Medical Women's Association (AMWA) joint project with The Difference in a Women's Heart, a national action campaign, and the American Heart Association. The Women's Heart Health Initiative goals are to heighten awareness through ongoing physician and patient education, facilitate early and accurate diagnosis of cardiovascular disease in women and increase efforts aimed at preventing significant health problems for women.

As one component of the heart health initiative, in 1994 AMWA developed a comprehensive "Education Project on Coronary Heart Disease in Women," to increase awareness of coronary heart disease in women and to train physicians in the appropriate and effective prevention, diagnosis, and treatment of heart disease in their female patients. The project is now in its ninth year. The National Association of Margarine Manufacturers is one of the supporters of this initiative.

In 1995, a Gallup Survey sponsored by the American Medical Women's Association was conducted, with a national sample of 505 American women, ages 45 to 75 years, and 300 physicians practicing in the primary care specialties of: internal medicine, family practice, or OB/GYN. Survey results included a common myth: heart disease is a man's disease.

Common Myths held by women of heart disease

The Gallup survey indicated that:

• 80 percent do not know that heart disease is the leading cause of death for females.
  
  
• 70 percent believe heart attack warning signs are the same for women as they are for men (when in actuality, they can be significantly different).
  
  
• Only 50 percent know that menopause increases a woman's risk for heart disease.

In the survey, many of the same myths held true with physicians:

What women ages 45 to 75 believe	What primary care physicians believe	Actual Facts
4 out of 5 women did not know heart disease is their leading cause of death	32% of physicians did not know heart disease is the leading cause of death in women.	Heart disease is the leading cause of death in American women.
Half of women did not know menopause increases their risk for heart disease.	2 of 3 physicians think risk factors for heart disease are the same in men and women.	Women have different risk factors for heart disease.
70% of women reported warning signs for heart disease are the same in women and men.	88% of physicians believe the signs and symptoms of heart disease are the same for women and men.	Women's symptoms of heart disease often differ from men's.
86% of women were confident in their primary care physician's ability to diagnose heart disease in women; 84% would go to a primary care physician to evaluate their risk for heart disease.	78% of physicians have not increased the number of women referred for cardiology consultation; 68% report no change in the number of women evaluated for heart disease.	Primary care physicians hold the key to early detection and improved outcome.
83% of women felt at least moderately informed about heart disease in women.	89% of primary care physicians feel physicians need more education about heart disease in women; 42% believe that need is high or extremely high.	Primary care physicians and women need to know more about heart disease.

Other surveys of women and heart disease pointing to the same myths A survey by Prevention magazine found that only 33 percent of women surveyed knew that their chance of dying from breast cancer is less than that from a heart attack. In fact, the risk is five times higher, but 58 percent thought it was lower or the same risk.

The National Center for Health Statistics of the Department of Health and Human Services also found similar myths when it comes to women's health. (see chart below)

Percentage of women who perceive their most serious health threats as:
Breast Cancer	46%
Unspecified Cancer	16%
AIDS	4%
Heart Disease	4%
Uterine and Ovarian Cancer	3%
What women's most serious health threats really are (incidence of disease)
Heart Disease	36%
Breast Cancer	4%
Unspecified Cancer	3%
Uterine and Ovarian Cancer	2%
AIDS	<1%
Source: National Center for Health Statistics, 1990

Other information on women and heart disease:

• A woman who has a heart attack is one-and-a-half times as likely as a man to die from it, and, if she survives, more likely to have a second one.
  Framingham Heart Study.
  
  
• In women, the rate of death from heart disease far exceeds that of breast cancer. One woman in 29 dies of breast cancer. One in 2.4 dies of cardiovascular disease, including a heart attack or stroke. Heart disease is the number-one killer of women.
  2003 American Heart Association Heart and Stroke Statistical Update.
  
  

A Woman's Heart is Different than a Man's Heart
Many people believe that women do not develop heart disease as often as men and that when a woman experiences chest pain it can be attributed to noncardiac causes. This is a myth. Women do develop heart disease, but their symptoms are different from men's symptoms. The classic cardiac symptoms have been based on what men typically experience, making it easier to identify heart disease in men. For example, a man may feel chest discomfort (angina) during stress or exertion. In contrast, a woman may have chest discomfort that comes and goes or shortness of breath with stress or exertion. So what's typical for a man may not be typical for a woman. Review the following list of the most common signs and symptoms of a heart attack.

Heart Attack signs and symptoms in women
Angina - A tightness, pressure, or squeezing felt in the chest, throat, upper abdomen, or neck that can radiate down the left arm, causing tingling or numbness.

Difficulty breathing - Occurs with or without exertion; waking up breathless at night.

Nausea/indigestion-like symptoms - Heartburn and/or feeling sick to your stomach.

Fatigue - General weakness and/or lack of energy.

There are other explanations for these symptoms. If a woman has any of these symptoms, she should talk to her doctor. Only a doctor can diagnose heart disease.

More about AMWA
The American Medical Women's Association is an organization of 10,000 women physicians and medical students dedicated to serving as the unique voice for women's health and the advancement of women in medicine. AMWA was founded in 1915, at a time when women physicians were an under-represented minority. As of 1998, 23% of all practicing physicians are women. By 2010, it is expected that 30% of all physicians and 50% or more of all medical students will be women. Some of the women's health issues AMWA has worked to improve include heart disease, smoking prevention and cessation, osteoporosis, violence against women, gender equity, breast cancer, and reproductive health.