During 2003, an estimated 1.1 million Americans will have a first or recurrent heart attack, and approximately 700,000 will die of heart disease. Recognizing and responding promptly to heart attack symptoms and receiving prompt, appropriate care is vital to saving lives and to preventing permanent damage to the cardiovascular system.
FDA NEWS: FDA Clears New Lab Test to Help Rule Out Heart Attack
What You Need to Know About Women and Cardiovascular Diseases
The common belief that cardiovascular disease (CVD) affects mostly men is a dangerous myth. According to the American Heart Association:
- Cardiovascular disease is responsible for twice the number of deaths in women than all forms of cancer combined.
- More than 40% of all female deaths in America and most developed countries occur from CVD, especially coronary heart disease and stroke.
- 38% of women compared with 25% of men will die within one year after a heart attack.
- Stroke is the number 3 cause of death in America and a leading cause of serious, long-term disability; between 15 and 30% of stroke survivors are permanently disabled.
- According to a survey conducted by Yankelovich Partners, Inc. in 1997, only 8% of women in America believe that heart disease and stroke are the greatest health threat to women.
It is vital that women be informed and aware of the risks, diagnosis and treatment associated with CVD.
- The risk of heart disease and stroke increases with age.
- More women than men die of stroke.
- Low blood levels of "good" cholesterol (high density lipoprotein or HDL) are a stronger predictor of heart disease death in women than in men; high blood levels of triglycerides may be a particularly important risk factor in women and in the elderly.
- Diagnosis of heart disease is frequently more difficult in women than it is in men.
What are the Heart Attack Warning Signs?
Most heart attacks start slowly, with mild pain or discomfort. Frequently people affected aren't sure what is happening and wait too long before getting help. The following are the common signs of a heart attack in women:
- Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back.
- Women frequently experience less severe chest pain, but more significant abdominal or shoulder pain, than men.
- Pain that spreads to the shoulders, neck or arms.
- Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.
Other signs include nausea, dizziness, shortness of breath or difficulty breathing all without chest pain; unexplained anxiety, weakness or fatigue, cold sweats; swelling, particularly of the ankles or lower legs.
If you experience any of the warning signs, don't wait. Call your emergency medical services and get to a hospital immediately.
What are the Stroke Warning Signs?
According to the American Stroke Association, these are the warning signs of stroke:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
- Sudden confusion, trouble in speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
If you or someone with you experiences one or more of these signs, immediately call emergency medical services, preferably an ambulance with advanced life support. Check the time so you will know when the first symptoms appeared. It is very important to take immediate action; a clot-busting drug given within three hours of the start of symptoms can reduce long-term disability for the most common type of stroke.
New Diagnostic Testing Recommendation
For several years evidence has been building that painless inflammation may be a major indication of heart trouble, worse even than high cholesterol. In the February issue of the journal Circulation, the American Heart Association and the Centers for Disease Control and Prevention issued guidelines urging doctors to consider testing millions of American at moderate risk of heart disease for signs of inflammation in the bloodstream. The inflammation, which comes from many sources, including gum disease, lingering urinary infections, etc. triggers heart attacks by weakening the walls of the blood vessels and making fatty buildups burst. It can be measured with a test that checks for C-reactive protein, or CRP, a chemical necessary for fighting injury and infection.
The guidelines suggest limiting the testing to people already judged to be at 10 to 20 percent risk of heart disease over the next 10 years, based on such factors as age, high cholesterol and high blood pressure. In the U. S., this category is estimated to encompass 40 percent of the adult population.
Evidence backing the importance of inflammation in heart disease comes from research at the Brigham and Women's Hospital in Boston. One of the latest studies of women found that half of all heart attacks and strokes occurred in people with seemingly safe cholesterol levels. Those with high CRP had double the risk of women with low levels. The average CRP reading in the U.S. is 1.5; the Brigham and Women's studies show that the risk if dramatically higher when the CRP level hits 3.
The CRP test is the first new blood test to be accepted to check for the risk of heart disease since cholesterol screening became standard 30 years ago.
High levels of CRP can be lowered by the same techniques that bring down cholesterol, i.e. exercise, weight loss, quit smoking and statin drugs.
Taking Steps to Prevent Cardiovascular Disease
According to the Mayo Clinic the best way to prevent heart problems in the future is to adopt a healthy lifestyle today. That includes the following five strategies:
- Don't smoke - This is the most powerful preventable risk factor for heart disease. No amount of smoking is safe. When you quit, your risk of heart disease drops dramatically within 1 to 2 years; after 10 to 15 years, is nearly as low as a nonsmoker's.
- Exercise - You can reduce your chance of CVD by 30 to 50 percent just by staying active. Exercise increases blood flow to your heart and enables the heart to pump more blood with less effort. It also helps you control your weight and reduce the chances of developing high blood pressure, high cholesterol and diabetes.
- Eat a heart healthy diet - This can be as simple as adding more grains, vegetables and fruits and limiting fat, especially saturated fat from your diet. Fruits, vegetables, grains and legumes contain many of the nutrients and other substances that may protect you from heart disease. These include antioxidants – vitamins C and E and the carotenoids; Omega-3 fatty acids found mainly in fatty cold-water fish; and dietary fiber.
- Maintain a healthy weight - As you put on weight, it is mostly in the form of fatty tissue. This tissue relies on oxygen and nutrients in the blood to survive; this increases the amount of blood circulating through your body and puts added pressure on the artery walls. Excess weight can also lead to high blood pressure, high cholesterol and diabetes.
- Know your numbers - regular blood pressure checks and blood-lipid screenings play an important role in discovering early heart problems. They also provide a way to measure the impact that lifestyle has on your heart.
Above all, women need to take a more active role in preventing cardiovascular disease. Discuss the risk factors with your doctor; make sure that any warning signs don't go unheeded.
Dolores C. - Health Issues Committee
SOURCES: American Heart Association, The American Stroke Association, Mayo Clinic, Center for Disease Control and Prevention, The National Heart, Lung and Blood Institute.