Heart Disease in Women Q&A
05.20.2015
Heart disease is more prevalent in men than women, and remains the leading cause of death for both sexes. Cardiovascular disease, on the other hand, which also includes heart failure, hypertension, and stroke, is more prevalent in women.
Likewise, each year, more women than men die of cardiovascular disease. Six times as many women die from heart disease as from breast cancer— about 500,000 each year.
An estimated 8 million American women suffer from heart disease. One out of every four women will die of heart disease, and one out of every two will die of cardiovascular disease. Women have more heart attacks than men that go unrecognized.
Two out of every three women who die suddenly of heart disease have no prior history of cardiovascular disease.
Several risk factors can raise your risk, including:
- A family history of cardiovascular disease
- High blood pressure
- Diabetes
- Smoking
- Abnormal cholesterol
Even if you have normal cholesterol, after menopause, the amount of low-density lipoproteins, or LDL (“bad cholesterol”), may increase because of the lowered levels of estrogen.
Your risk of developing high blood pressure, diabetes, and cardiovascular disease increases if:
- You are overweight or obese
- Have an unhealthy diet (including excessive alcohol consumption)
- Don’t exercise regularly
You can lower your risk significantly by:
- Eating a heart-healthy diet that is low in saturated fat, sugar and salt
- Maintaining a healthy weight
- Being physically active
- Limiting the amount of alcohol you drink
- Not smoking
Psychological distress can be a risk factor. Women with depression and anxiety are more likely to die of heart disease. Women are also more prone to depression than men after a heart attack—and that raises the risk of another attack.
Chest pain is the classic symptom of a heart attack, but it can also feel like pressure, tightness, squeezing, or burning. Women can have other symptoms, too:
- Shortness of breath
- Light-headedness, dizziness
- Nausea or vomiting
- Sweating
- Unusual fatigue
- Arm or shoulder pain, usually left-sided, but may be right-sided
- Pain in neck, jaw, back, or abdomen
Finding a clinician who specializes in women’s heart health raises the odds that you’ll be evaluated by someone who knows what to look for and how to look for it. Clinician’s current standards for diagnosis are primarily based on research performed on men.
Women are more likely to get misdiagnosed or go undiagnosed because the symptoms they experience may not be consistent with these standards. In addition, women are less likely to be referred for appropriate testing.
Many women experiencing symptoms may have a normal stress test or angiogram, which are tests often used to evaluate chest pain. Heart disease in women can affect smaller blood vessels instead of the large ones assessed in these standard tests.
Stanford is one of the few heart centers in the U.S. using special testing techniques tailored to find the microvascular disease or endothelial dysfunction that is more prevalent in women.
For many women, a treatment called percutaneous coronary intervention, or PCI, will be appropriate. The procedure passes a catheter, or narrow tubing, through arteries until the catheter reaches the site of a heart blockage.
Once there, a balloon is inflated within the artery to relieve the blockage and restore blood flow. Traditionally, the catheter was inserted in an artery in the groin. In women, however, that location produces two to three times the rate of bleeding and vascular complications.
Jennifer Tremmel, MD, SM, Clinical Director of Women’s Heart Health at Stanford, uses a transradial approach, inserting the catheter in the radial artery, an artery in the wrist. The transradial PCI cuts the rate of bleeding and complications by half.
Women’s Heart Health at Stanford has been growing since it started in 2007.
Clinical care continues to become increasingly comprehensive with specialists in:
- Preventive cardiology
- Psychology
- Valvular heart disease
- Arrhythmia
- Peripheral vascular disease
- Coronary artery disease
In addition, ongoing research studies add a greater understanding of how best to care for women patients. Women’s Heart Health at Stanford has many research studies, including:
- Chest pain with normal heart arteries
- Coronary artery dissection
- Peri-partum weight gain
- Diet and exercise interventions
- Mindfulness for the improvement of heart health
Moreover, Women’s Heart Health is supporting other researchers at Stanford studying how women differ from men.
Learn more about Women's Heart Health at Stanford, or call 650-723-6459.