William Penn Life, 2003 (38. évfolyam, 1-12. szám)
2003-03-01 / 3. szám
Women and Heart Disease Women-and doctors-need to know this killer is not a 'men-only' concern from www.womenheart.org Coronary heart disease (CHD), long thought of as primarily affecting men, also affects a substantial number of women. More U.S. women die from heart disease than any other cause. Experts estimate that one in two women will die of heart disease or stroke, compared with one in 25 women who will die of breast cancer. Current statistics also reveal significant differences between men and women in survival following a heart attack. For example, 42 percent of women who have heart attacks die within one year compared with 24 percent of men. The reasons for this are not well understood. The explanation accepted by many is that women tend to get heart disease later in life than do men and are more likely to have coexisting, chronic conditions. However, research also has shown that women may not be diagnosed or treated as aggressively as men. Gender differences Women have smaller hearts, weighing 50 to 100 grams less than men's. Their hearts also beat faster, and their arteries are finer and more fragile. In addition, the interplay of their anatomy and hormones influences their cardiovascular systems in unique ways. These differences affect virtually all aspects of their care. One surprise is that women don't always suffer from the classic male symptom of crushing chest pain. About 15 to 20 percent of women having a heart attack specifically complain of pain high in the abdomen, shortness of breath, and profuse sweating. Preceding or during an attack women may also complain of chronic fatigue, indigestion, pain in the back or jaw, and heart palpitations. Such diffuse symptoms can easily masquerade as run-of-the-mill problems like heart bum or a favorite Health Links For more information on women and coronary heart disease, log onto the following websites: 3 WomenHeart: the National Coalition for Women with Heart Disease www.womenhean.org 3 National Heart, Lung and Blood Institute www.nhlbi.nih.gov.healthl hearttruth 3 American Heart Association www.americanhean.org/ simplesolutions 3 Office on Women’s Health, U.S. Department of Health and Human Services www.4woman.gov medical culprit-mental stress. Gender also plays an important role in the evaluation of cardiac risk factors. Early menopause, by depriving the body of estrogen's heart protective benefits, is an obvious example of a risk factor unique to women. Other major risk factorselevated cholesterol, smoking high blood pressure, diabetes and obesityare shared by the sexes but vary between them in subtle and sometimes dramatic ways. For a woman, total cholesterol is not as strong an indicator of heart disease as for a man. What counts most is the level of her HDL or good type of cholesterol. Yet national guidelines define an unhealthy HDL level as below 35. That's appropriate for a man, but ideally it should be over 45 for a woman. Smoking is bad for the heart, but mounting clinical evidence points to worse consequences for female smokers than male ones. Women who smoke on average suffer heart attacks 15 years earlier than those who don't, whereas male smokers typically have heart attacks seven years earlier. Excess weight has long been linked to heart disease, but when it accumulates around the waist, females are especially prone to a cluster of conditions that damage the cardiovascular system. This group of conditions includes high blood pressure, low LDL, and insulin resistance (a precursor to diabetes and a contributor to plaque formation). Keys to detection Clearly, an awareness of predisposing factors holds the key to catching a woman's disease early, before she suffers a heart attack. But many doctors aren't even screening their female patients for the most salient risk factors, so entrenched is in the view that heart disease is a male problem. What can women do to prevent heart disease and improve their care? First, they need to recognize their risk and be alert to the symptoms. Just as important, women should get an annual physical and be thoroughly screened for risk factors by a doctor sensitive to how heart disease affects them. A proper check up should not only include a complete blood work up (with a woman's cholesterol broken down into HDL, LDL and triglyceride fragments), but her heart's electrical activity should be analyzed with an EKG machine. Though far from a perfect instrument, it's useful at detecting abnormalities that can signal arterial blockages and other heart problems. If her EKG suggests potential heart disease, or if she has two or more risk factors (especially if one of her risk factors is a low-HDL score) a woman should be referred to a cardiologist for evaluation. IffHj Villiu Pen Life, March 2003 5
