UR Medicine's Thompson Health

WIN 2016

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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1 1 w w w. s p i r i t o f w o m e n . c o m W I N T E R 2 016 S P I R I T O F W O M E N SHUTTERSTOCK F ifteen years ago, only one-third of U.S. women realized that heart disease was their No. 1 killer. While the risk is better understood today—that number has climbed to one-half—many women still don't act on their knowledge, says Dr. Nanette Wenger, professor of medicine in the Division of Cardiology at Emory University School of Medicine, Atlanta. Some are in denial about their risk factors, while others fall into the habit of taking better care of loved ones than of themselves. And that's unfortunate because "after a heart attack, the long- term survival prospect is as good or even better for women than for men, as long as they get appropriate treatment," according to Dr. Wenger. By understanding that heart health is just as important for you as it is for the men in your life, you can take steps to reduce your risk of cardiac disease. Being familiar with heart symptoms specific to women will allow you to identify them and get them treated earlier. GENDER DIFFERENCES To begin with, heart disease can take different forms in men and women. "Diastolic heart failure [a decline in the performance of one or both ventricles, which pump blood] is more common to women," says Dr. Delia Dobrescu, a cardiologist at Monmouth Medical Center in Long Branch, N.J. "This is different in men, where the leading cause is ischemic heart disease [clogged arteries]." Symptoms of cardiac problems also can be different for each gender, says Dr. Wenger. "Men tend to present with the classic differences, says Dr. Cecelia Hirsch, a cardiologist affiliated with North Colorado Medical Center, Greeley, Colo. "Some of the factors are more serious for women," she says. "For instance, diabetes is more predictive of heart disease for women than for men. And smoking elevates the risk more for women. The good news is that the risk from smoking decreases dramatically within two or three years of [a person] quitting." In addition, women are generally more susceptible to emotional stress, further amplifying their risk, says Dr. Dobrescu. Regular, age-appropriate screenings can help you combat your risk factors, along with eliminating the risks over which you have control: quitting smoking, seeking treatment for diabetes and hypertension, and regularly exercising and watching your diet. The American Heart Association recommends that women as young as 20 years old be screened for cardiovascular disease, with the frequency of follow-up screenings based on your individual risk factors. • symptoms of chest pain or some kind of central chest discomfort," she says. "Women can also experience chest pain but might just have extreme weakness or fatigue," along with nausea and shortness of breath. Dr. Wenger adds that there is also a gender split in what triggers a heart attack. "For men, that trigger is predominantly physical activity, exercise," she explains. "In women, it's also emotional provocation—anger or fear." And this creates another challenge for women, says Dr. Wenger. "If the symptoms are activity-triggered, [when the activity stops] the demand on the heart stops, and symptoms go away," she says. "When it is emotionally triggered, you can't turn off that stimulus as promptly, so the symptoms tend to persist longer. Since physical activity is under control and emotions aren't, this explains why women tend to have more severe symptoms and to report more impairment to quality of life with heart disease." RISK FACTORS Despite some gender differences in the symptoms and types of heart disease, most risk factors are shared. Your individual risk is more dependent on your genetics, habits and lifestyle decisions than it is on your gender: • age 45 or older • high cholesterol • high blood pressure • untreated diabetes • smoking • obesity and a sedentary lifestyle • family history of heart disease While this list is the same for men and women, there are important DANGER signs If you experience any of the following symptoms of a heart attack, call 911 or go to the nearest emergency room immediately: • Uncomfortable pressure, squeezing, fullness or pain in the center of your chest • Pain or discomfort in one or both arms, your back, neck, jaw or stomach • Shortness of breath (with or without chest discomfort) • Breaking out in a cold sweat, nausea or lightheadedness Source: American Heart Association

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