Women More Aware of Heart-Disease Risk...

... But treatment still doesn't equal that of men, studies find

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By Serena Gordon
HealthDay Reporter

TUESDAY, Jan. 31, 2006 (HealthDay News) -- The good news is that women are becoming more aware of their heart-disease risk, experts report. The bad news is that many still aren't getting the treatment they need.

"Heart disease is the number one cause of death in women. Cardiovascular disease causes more than 480,000 [female] deaths each year," said Dr. Alice Jacobs, past president of the American Heart Association (AHA). Yet, Jacobs said, "Women's chest pain is not taken as seriously as men's."

In a Feb. 1 special themed issue, the association's journal Circulation takes a closer look at the state of women's heart health in the United States.

The first report in the issue looks at a national study of more than 1,000 women aimed at assessing women's awareness of their risk of coronary disease.

First conducted in 1997, the study initially found that only 30 percent of women were aware that heart disease is the leading cause of death among women. Today, that number is 55 percent.

Unfortunately, that message doesn't appear to have been equally distributed. According to the study's lead author, Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital in New York City, "We still have much work to do among the populations that are most at risk."

She said that 62 percent of white women said they realized the threat heart disease poses, but just 38 percent of black women and 34 percent of Hispanic women did.

Heart disease claims more women's lives than the next five leading causes of death combined, including cancer, chronic obstructive pulmonary disease, Alzheimer's disease, diabetes and accidents, the study authors said. According to the AHA, one in every 2.6 female deaths is from cardiovascular disease (cardiovascular disease includes heart disease and stroke.)

Mosca said the researchers also asked about barriers to treatment, and nearly half of the women said they were confused by some of the messages they've received from the media, such as conflicting study reports. Another large barrier -- 44 percent -- was the belief that God or some higher power ultimately determined their health. One in three women said she didn't feel at risk for heart disease, and 42 percent felt they were too busy taking care of others to seek treatment for themselves.

The researchers also found that women who were more aware of their risk of heart disease were more likely to take action. And there are many factors that can motivate women to work on their heart health, such as feeling better, living longer, avoiding taking medications and helping their family be healthy, the study found.

Here are some of the other findings reported in this issue of the journal:

  • British researchers found that women with stable angina (chest pain upon exertion) received less-aggressive treatment than men with the same complaint. According to the study, women with angina were less likely to have an exercise EKG (stress test), to have angiography, or to be prescribed anti-platelet therapy or cholesterol-lowering medications. "Women who have coronary artery disease have to prove themselves very ill to get a coronary angiogram," said the study's lead author, Dr. Caroline Daly, of the Royal Brompton and Harefield National Health Service Trust in London.
  • After coronary bypass surgery, women are 1.5 times more likely than men to need to go back to the hospital, according to a Canadian study from the Institute for Clinical Evaluative Sciences. Plus, women have an increased risk of a worse outcome than men after this surgery, the researchers found.
  • A Harvard study may finally put the fat-versus-fit debate to rest. Among a group of more than 88,000 women from the Nurses' Health Study, the researchers found nearly 2,400 cases of heart disease. When they compared the effects of overweight and obesity to those of an active lifestyle, the researchers discovered that being lean -- whether lean and sedentary or lean and active -- trumps being fat and fit. Lean, sedentary women had a 50 percent higher risk of heart disease than lean, active women. But obese active women had 2.5 times the risk than lean, active women, and obese, sedentary women had a 3.5 times higher risk of heart disease. The highest risk of all was seen in women who were obese, sedentary and smokers -- their risk was 9.4 times higher than that of lean, active, non-smoking women.
  • A study from Wake Forest University details new signs of heart-disease risk that can be found in the electrocardiograms (ECG or EKG) of post-menopausal women. According to the study author, Dr. Pentti Rautaharju, about one in 10 women has what's called a wide QRS/T angle that is associated with an increased risk of cardiac death and heart failure. Evidence of an old heart attack on ECG is associated with a two-fold increase risk of congestive heart failure.

"Women need to know that heart disease is their number one killer," said cardiologist Dr. Mary Ann McLaughlin, of Mount Sinai Medical Center in New York City. She said women should be on the lookout for "atypical" symptoms, such as nausea, perfuse sweating, back pain with no explanation, numbness or tingling down one arm or in the jaw. It's much better to come in and have heart symptoms ruled out that to wait until symptoms become more severe, she added.

"As a cardiologist, I'd rather get called in for things that turn out to not be heart-related. We don't want women to feel embarrassed to come in for symptoms that may not be heart-related. EKGs taken when you're feeling symptoms are really important. Later, your EKG can look completely normal," she said. McLaughlin added that, sometimes, women still have to be assertive in the emergency room and request a cardiologist.

More information

To learn more about women and heart disease, visit the American Heart Association.

SOURCES: Lori Mosca, M.D., Ph.D., director, preventive cardiology, New York-Presbyterian Hospital, New York City; Caroline Daly, cardiologist in training, Royal Brompton and Harefield National Health Service Trust, London, England; Pentti Rauthaharju, M.D., Ph.D., emeritus research professor, Wake Forest University, Winston-Salem, N.C.; Mary Ann McLaughlin, M.D., M.P.H., cardiologist, Mount Sinai Medical Center, New York City; Feb. 1, 2006, Circulation

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