Expert: Women's Heart Woes Have Stepchild Status

Urges more attention be paid to top killer

THURSDAY, May 13, 2004 (HealthDayNews) -- Heart disease is the No. 1 killer of women over the age of 45, and yet it ranks low on women's and doctor's perceptions of major health risks.

"We have made headway in the treatment of cancer, but the death rates for heart disease in women are up while, in men, they are dramatically reduced," said Dr. Norma Keller, chief of cardiology at Bellevue Hospital who was expected to deliver a presentation on the finding Thursday at an American Medical Association (AMA) briefing in New York City.

"When it comes to women, this is often not at the forefront of disease awareness," Keller added.

Each day, 1,400 women die of heart disease, which has been the top killer of women for a century.

Part of the problem is that the symptoms of a heart attack in women can be different than those in men, and may be attributed to stress more quickly than to cardiovascular problems, Keller said.

"Women and doctors are not thinking about it," said Keller. "We're still behind the eight ball when it comes to physician awareness. Therefore, it's important for women to advocate about their own health."

And the warning signs are there. More than half of women over the age of 45 have high blood pressure, 40 percent of women over 55 have high cholesterol, and 22 million American women are still smoking, Keller pointed out. Women, however, are less likely to get lifesaving cholesterol-lowering medication.

The good news is that these risk factors can be changed. "A lot of it is lifestyle. There is so much women can do about heart disease," Keller said. "Even though these are awful numbers, almost all of these things we can do something about."

Keller was just one of several specialists speaking at the AMA briefing.

Dr. Kevin Donahue of Johns Hopkins University School of Medicine was to address innovations in treating atrial fibrillation, an irregular heart rhythm that increases the risk of stroke, heart failure, and heart attacks.

Radiofrequency ablation, which involves inserting catheters and radio energy into the heart, cured 60 percent to 80 percent of patients who had no other heart disease. Various drugs that are designed to block a certain potassium channel are in early clinical trials, and gene transfer techniques are showing some promise, albeit only in animal models.

Embryonic stem cells, which may be able to regenerate damaged heart muscle in congestive heart failure patients, are another avenue of exploration, according to Dr. Theo Kofidis, a research fellow in cardiothoracic surgery at Stanford University Medical School. These results appear in the June issue of the Journal of Heart and Lung Transplantation.

Finally, Dr. Dimitri Cassimatis, a cardiology fellow at Walter Reed Army Medical Center in Washington, D.C., was to speak of higher-than-expected cardiac complications from smallpox vaccinations given to military personnel in recent years.

Between December 2002 and June 2003, almost 500,000 military personnel had been vaccinated. Non-heart-related side effects were as expected, and sometimes even lower. However, the rate of myopericarditis (an inflammation of the heart muscle or of the sac surrounding the heart) was about eight out of 100,000 in those who were vaccinated for the first time, Cassimatis reported. This particular side effect has almost never been seen before in the United States.

But the overall rate is still small, about 50 cases all together, and almost all patients have returned to normal.

"While the total number affected remains relatively small, we must recognize that the administration of smallpox vaccinations has been limited," Cassimatis said in a prepared statement. "The numbers could rise significantly if a more widespread civilian vaccination program was implemented. We need to better understand the potential complications with this small group, so we are adequately prepared to address complications on a larger scale if that ever becomes necessary."

More information

The National Institutes of Health and the American Heart Association have more on women's heart health.

SOURCES: Norma Keller, M.D., chief of cardiology, Bellevue Hospital and assistant professor of medicine, New York University School of Medicine, New York; American Medical Association, news releases, May 13, 2004
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