MountainView Hospital February 08, 2015

Heart disease often is perceived as a male epidemic, but it has killed more women than men each year since 1984, according to the American Heart Association. While the threat to men isn’t exaggerated, heart disease is the No. 1 killer of both men and women in the United States. One in 3 women will die of heart disease, but only 1 in 5 women believe heart disease is their greatest health risk, the American Heart Association found.

The Centers for Disease Control and Prevention estimates at least 25 percent of deaths caused by heart disease are preventable. Knowledge truly is power when addressing heart disease, and while awareness about women’s heart health has progressed in recent years, we still have a long way to go.

Dr. Navid Kazemi, MD, FACC at MountainView Hospital, explains why heart disease in women has been overshadowed and what women can do to keep their hearts healthy.

Why awareness among women is lower

“Heart disease is the most important health problem women should focus on as they grow older, but many times, women are not aware of their risk,” Kazemi said. “They don’t believe they’re as likely to get heart disease, and so they often don’t identify the signs. The majority of what we’ve learned about heart disease in the past is based on studies that were mostly inclusive of men. It has only been in the past 10 to 20 years that women are being enrolled into clinical heart studies.”

While the number of women enrolled in heart studies has increased dramatically, the American Heart Association reports that women account for only 24 percent of participants in all heart-related studies.

“We are seeing how heart disease can be different in women and men, but we do not have a proportionate knowledge base between the genders,” Kazemi said.

Signs of heart disease in women

  • Shortness of breath
  • Chest pain, pressure or discomfort
  • Excessive, unexplained fatigue
  • Swelling in the feet or ankles
  • Increased heart rate

Menopause increases risk

Everyone becomes more susceptible to heart disease and high blood pressure as they grow older, but menopause can further increase certain risk factors for women.

“During menopause, the amount of estrogen and progesterone the body produces decreases, which causes metabolic changes,” Dr. Navid Kazemi said. “Blood pressure might start to go up and HDL (“good” protective cholesterol) might decrease, while LDL cholesterol (“bad” cholesterol) tends to increase, which can indirectly cause plaque buildup.”

Though menopause doesn’t cause heart disease, it can increase the risk. “The era after menopause is when women should be the most cautious about developing heart disease,” Kazemi said.

Post-menopause, women should continue to strive for a healthy lifestyle, including eating a nutritious diet, keeping a steady exercise routine, monitoring their blood pressure and prioritizing an annual checkup.

Check your blood pressure regularly

“A yearly examination by a physician is the key to success,” Dr. Navid Kazemi said. “The most important thing is for women to go in and have their blood pressure checked. They should also have a discussion with their physician about how physically active they are; that can provide a lot of information.” Normal blood pressure for women is below 120/80.

Don't smoke

“In the past 20, 30 years when people started smoking, the majority of the people who smoked were men, and that was a major cause of the eventual development of heart disease,” Dr. Navid Kazemi said. “As the number of men who smoked decreased, there was a period of time where actually the number of women smokers increased.”

Exercise is critical: 120-150 minutes per week

The best way to keep your heart healthy is to exercise regularly and eat a healthy diet.

“Maintaining a regular exercise routine not only will help prevent heart disease but also will help alert a patient who has developed heart disease,” Dr. Navid Kazemi said. “If people exercise regularly, and they develop heart disease, they will know sooner than anyone else because their exercise tolerance will change, they will get short of breath more often with the same level of exercise they’re used to, or they’ll feel vague discomfort in their chest.”

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