Women: No. 1 Disease Is a Heartbreaker

Most don't know heart disease is their top killer

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By
HealthScout Reporter

TUESDAY, May 15 (HealthScout) -- What women don't know about heart disease could kill them.

While statistics show heart disease is the No. 1 killer of women, a new survey by the American Heart Association (AHA) shows that most of 1,004 women polled, or 62 percent, consider cancer to be their top health risk. Only 34 percent believe heart disease is their deadliest enemy.

Heart disease killed 503,927 women in 1998, twice as many as the 259,467 killed by cancer, says the AHA.

The survey updates a 1997 poll about how women perceive their health risks, how much they worry about them and how they are getting information about heart disease and stroke. Although there were slight gains in awareness in the last four years, experts say women still have a long way to go before their perception of heart disease matches reality.

"I think the fact that women really don't understand what their major risk is means they're not taking action against that risk," says Dr. Rose Marie Robertson, president of the AHA and medical director of the Vanderbilt Women's Heart Institute. She wrote an editorial that accompanies the survey, which appears in tomorrow's Circulation: Journal of the American Heart Association.

"It's not just a man's disease," says Dr. Nieca Goldberg, chief of the Women's Heart Program at Lenox Hill Hospital in New York City. "Awareness is going to help women take the next step."

While many women polled knew heart disease can develop slowly and shows few symptoms, the survey found other fictions that most women thought were fact.

For instance, 54 percent of women polled thought that estrogen in hormone replacement therapy (HRT) can reduce the risk of heart disease. Several recent studies found it doesn't slow down heart disease in older women. The National Institutes of Health is studying whether estrogen replacement therapy can reduce the risk of heart attack in healthy women. Called the Women's Health Initiative, researchers say that study should be finished in 2005.

"That [study] should help us a lot, but we really don't have hard evidence right now about the primary role of HRT in heart disease. We don't have the absolute answer yet. Women shouldn't be taking it and thinking, 'It protects my heart, so I don't have to do anything else,'" Robertson says.

Another misconception women have is that heart disease hits later in life, Robertson says. Thirty-five percent of those surveyed said they believed heart disease develops between ages 35 and 49. Evidence shows that atherosclerosis, or hardening of the arteries, can begin in adolescence.

"The idea that you're fine until you're menopausal just isn't true," Robertson says. Several studies have examined the arteries of youths who have died of other causes and have found atherosclerosis can start in the teens, 20s and 30s, she says.

Part of the problem may be the sources of information on heart disease, she says. Of the 75 percent of women surveyed who said they received information about heart disease, 43 percent said the got the information from magazines; only 20 percent reported they were informed by health-care professionals about heart disease.

Goldberg says, "We have so many reports in the media that are confusing," so doctors need to step up. "It's not only a wake-up call for women, but also for health-care providers."

Robertson says, "It does make the point that patients are ready for the information. We'd better give it to them."

Doctors also might want to tell their women patients that a heart attack is particularly dangerous for them. Not only are the signs of an impending attack different for women, including pain in the shoulder, upper back, neck or jaw and difficulty breathing, the results usually are far worse, experts say.

Although most women surveyed knew that immediate treatment of heart attack and stroke was crucial to stem damage, Robertson says hospital records tell a different story. In most hospitals, only 3 percent to 5 percent of men and women eligible for early stroke treatment actually got it. "That's primarily because they don't get there in time," she says.

Robertson says many of her male heart patients say they went to the hospital because their wives insisted, but her female heart patients rarely say that.

"I think the role of caretaker in the family … is still handled by women. There isn't anybody doing that for women," she says.

Goldberg says women worry first about their sons and husbands and fathers getting heart disease, and women "are left to be taken care of last."

AHA statistics show after a heart attack, 38 percent of women are likely to die within the next year, compared with only 25 percent of men.

Robertson says the good news is that medical advances have made most risk factors for heart disease controllable. Women just have to make use of them.

Goldberg says women need to make lifestyle changes, including eating a healthy diet, exercising and no smoking.

"The time has come for everyone to realize that women are at risk for heart disease, and we need to do something about it," Goldberg says.

What To Do

For more statistics on women and heart disease, click here.

The AHA has tips for women who want to avoid heart disease.

Read this report from Circulation: Journal of the American Heart Association for a comprehensive guide to preventing heart disease in women.

For more stories on heart disease and women, go to HealthScout.

SOURCES: Interviews with Rose Marie Robertson, M.D., president, AHA, medical director, Vanderbilt Women's Heart Institute, Nashville, Tenn.; Nieca Goldberg, M.D., chief, Women's Heart Program, Lenox Hill Hospital, New York City, spokeswoman, AHA; May 15, 2001, Circulation: Journal of the American Heart Association

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