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Heart Risk Assessment


Heart & Vascular Care for Women


Heart disease kills six times as many women as breast cancer – however, more than 60 percent of women believe their biggest health threat is breast cancer.

Surveys by the American Heart Association show that awareness of heart disease as the No. 1 killer of women is on the rise – awareness among women increased from only 34 percent in 2000 to 55 percent by 2005.

The misleading notion that heart disease is not a real problem for women can be blamed in part on medical research. Traditionally, heart disease studies focused primarily on men. Changes are under way, but some doctors still fail to recognize the warning signs displayed by female patients.

No. 1 Killer of Women

  • 23 percent of women will die within one year after having an initial recognized heart attack.
  • About 35 percent of women who have had a heart attack will have another within 6 years.
  • About half of women who have a heart attack will be disabled with heart failure within 6 years.
  • Heart disease has no quick fix – even if a special procedure is performed, heart disease will worsen unless treated with lifestyle changes and medication.

Since symptoms are different and sometimes milder for women, heart attacks may appear without warning.

Life-saving measures for women:

  • Understand the disease
  • Know the symptoms
  • Talk to your doctor
  • Manage individual risks

What is Heart Disease?

Heart disease refers to diseases of the heart and blood vessel system. A more correct term is “cardiovascular diseases,” which includes conditions such as coronary heart disease and high blood pressure. Having heart disease puts women at high risk for the fatal or debilitating results of heart attack, stroke and congestive heart failure.

Assess Your Risk

If you have two or more heart disease risk factors, discuss an action plan with your doctor.

  • Family history. Your father or brother under age 55, or your mother or sister under age 65, had a heart attack, stroke, angioplasty or bypass surgery.
  • Older age. You are over 55 years old.
  • Smoking. Either you smoke or you are exposed to secondhand smoke every day.
  • High blood pressure. Your blood pressure is over 120/80 or you have been told that you have high blood pressure.
  • Physical inactivity. You do not exercise for 20 to 30 minutes at least three days every week.
  • Diabetes. You have been told that you have diabetes or take medicine to help control your blood sugar.
  • Blood cholesterol levels (lipids). Your HDL is less than 35mg/dL or your total cholesterol level is over 240mg/dL.
  • Overweight. You are 20 pounds or more overweight.
  • Metabolic syndrome. A cluster of symptoms – having three or more of the following – equates to a risk factor.
    • blood sugar >110 mg/dL after fasting
    • triglycerides >150 mg/dL
    • HDL <50 mg/dL
    • blood pressure of 130/85 or higher
    • waist measures >35 inches
  • Hormones & menopause. You had a hysterectomy and had your ovaries removed or you have completed menopause.
  • Birth control pills. When combined with regular exposure to cigarette smoke, taking the pill greatly increases risks, especially after age 35.
  • Stress. Sustained high levels of stress and how you cope with it can affect your heart.
  • Alcohol intake. Excessive intake is more than 2 oz. of alcohol per day (one 5 oz. glass of wine, one 12 oz. beer or 2 oz. hard liquor).

Download:  Heart Risk IQ Questionnaire

Take Control

Research shows that women can lower their heart disease risk enormously – by 82 percent – simply by leading a healthy lifestyle.

  • Take these steps to lower your risk or prevent how rapidly your condition develops – the first two are critical:
  • Get moving. Aim for 30 minutes of physical activity every day – exercise fights more than heart disease.
  • STOP smoking.
  • Eat better. Less salt, cholesterol and fat, especially saturated fat.
  • Eat more fiber. Choose whole grains, fruits, vegetables and beans.
  • Weigh in often and maintain a healthy weight.
  • Ask your doctor about taking aspirin. Take all medicines as prescribed.
  • Manage your diabetes. Ask others to help you.
  • Know your numbers. Ask your doctor to check your blood pressure, cholesterol levels and blood glucose. Work with your doctor to improve any numbers that are not normal.

Sources: Women’s Health Foundation and National Heart Lung and Blood Institute

2007 Heart Disease Prevention Guidelines for Women

The American Heart Association’s Prevention Guideline Updates were released February 19, 2007.

Key changes to prevention recommendations:

  • Aspirin is recommended for women at high risk for heart disease or stroke and those older than 65 years, provided their blood pressure is under control. Routine aspirin is no longer advised for younger women unless the stroke prevention benefit is likely to outweigh the risk of side effects (particularly bleeding in the stomach).
  • Given the latest clinical trial results, neither hormone therapy nor selective estrogen receptor modulators (SERMS, e.g., raloxifene or tamoxifen) should be used for the prevention of heart disease or stroke. Vitamin and mineral supplements are no longer recommended as modes of preventing heart disease and stroke.
  • The 2004 guidelines had included folic acid supplements as an option for high-risk women with high levels of homocysteine. However, research studies fail to show a benefit for folic acid in preventing heart attacks or stroke.

More About Heart Disease

Heart disease refers to diseases such as coronary heart disease and high blood pressure.

Coronary Artery Disease


High cholesterol

Angina pectoris

Heart attack (myocardial infarction) When blood flow to part of the heart is reduced or stops, it causes that part to be damaged or die. A heart attack occurs when an artery becomes blocked, preventing oxygen and nutrients from getting to the heart. The damage is often reversible if the stoppage is brief, and the heart eventually receives the blood, oxygen and nutrients it needs.

Congestive heart failure (CHF) CHF means the heart doesn't pump as well as it should, causing the patient to retain fluids, often leading to swollen legs and ankles and congestion in the lungs. It is usually caused by a gradual weakening of the heart brought on by various conditions, such as clogged arteries or high blood pressure.

High blood pressure (hypertension) This is not a heart disease in the conventional sense; however, it strongly increases the risk of serious heart disease and stroke. It occurs when the pressure of blood flowing in the large arteries is too high. For adults, "too high" is generally defined as equal to or greater than 140 over 90.

Heart Attack Warning Signs

A study funded by the National Institute of Nursing Research found that women experience undiagnosed warning signs weeks, months and even years before having a heart attack.

Symptoms for women are strikingly different than men, and are often related to stress.

There are two categories of heart attack symptoms: pre-heart attack symptoms occur in the weeks and months leading up to a heart attack; acute symptoms are those you experience while you are having a heart attack.

The most common pre-heart attack symptoms in women are:

  • Unusual fatigue
  • Shortness of breath
  • Pain in the shoulder blade or upper back.

Common symptoms in women during an attack are:

  • Chest pain
  • Mid-back, neck or jaw pain
  • Nausea or vomiting
  • Shortness of breath
  • Palpitations
  • Indigestion

Although chest pain is the most common heart attack symptom in men and women, a substantial number of women do not experience chest pain during a heart attack.

Act in Time

Lifesaving heart attack treatments, such as clot busting drugs and balloon angioplasty, work best if given within the first hour after a heart attack begins. Many heart attack patients – especially women – wait two hours or more after their symptoms begin before they seek medical help. This delay can result in death or long-lasting heart damage, and it is one of the reasons why women tend to experience worse outcomes after a heart attack than men.

Learning to recognize the wide variety of symptoms will help you get the treatment you need fast – and may even save your life.