National Wear Red Day; Women and Heart Disease
Margo Kerrigan, M.P.H., Area Director
Indian Health Service California Area Office
On Friday, February 1, I encourage you to join millions of Americans in celebrating National Wear Red Day, a day to help raise awareness about women's heart disease. The Heart Truth campaign, sponsored by the National Heart, Lung, and Blood Institute of the National Institutes of Health, introduced the Red Dress as the national symbol for women and heart disease awareness. The Red Dress was chosen to remind women of the need to protect their heart health and to inspire them to take action.
Heart disease is the number one killer of women in the United States, claiming the lives of one out of every three women. In the US, twice as many women die from heart disease than from all forms of cancer combined. Almost a half-million American women died from heart disease and stroke in 2003. Yet only 20 percent of women identify heart disease as the biggest health problem facing women today.
There are many differences between men and women when it comes to heart disease. The start of heart disease is usually later in women than men due to the protective effects of female hormones before menopause. Also, women's heart disease symptoms may be different from men's symptoms. For example, a woman with heart disease might experience a severe migraine headache or an upset stomach instead of chest pain. Women have also reported unusual tiredness, trouble sleeping, problems breathing, indigestion, and anxiety. Often, women ignore these symptoms because they don't think they could be signs of heart disease.
There are different kinds of heart disease, but the most common is coronary artery disease (CAD). CAD occurs when the heart does not get enough blood, which can lead to a heart attack. The most common symptom of a heart attack in both men and women is some type of pain, pressure or discomfort in the center of the chest that lasts longer than a few minutes, or comes and goes. This pain may spread to one or both arms, back, jaw, or stomach.
However, many women do not experience chest pain during a heart attack, but do experience a range of different symptoms. Some common signs of a heart attack in women include:
- Pain or discomfort in other areas of the upper body, including the arms, back, neck, jaw, or stomach.
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or dizziness
- Unusual fatigue
Not every woman gets all of these symptoms. And, sometimes these symptoms go away and return.
Women are also less likely than men to believe they're having a heart attack and more likely to delay seeking treatment. If you experience these symptoms or think you're having a heart attack, call for emergency medical help immediately. Don't drive yourself to the emergency room. Every minute counts, even if the symptoms seem to disappear. The longer you wait to get medical treatment, the greater the likelihood that you will have severe, permanent damage to your heart or even die. The earlier the treatment, the more likely it is that damage to your heart will be kept to a minimum. Treatments are most effective if given within one hour of when the attack begins.
Heart attacks are generally more severe in women than in men. In the first year after a heart attack, women are more than 50% more likely to die than men are. In the first six years after a heart attack, women are almost twice as likely to have a second heart attack.
The best way to avoid a heart attack is prevention. Many of the major risk factors for heart disease can be controlled, including high blood pressure, high blood cholesterol, obesity and overweight, physical inactivity, and smoking. Other risk factors include diabetes, family history of heart disease, and age.
Here are some ways to help prevent heart disease:
- Get regular medical checkups to monitor your blood pressure, cholesterol and blood glucose.
- Stop smoking. Studies show that smoking lowers levels of good cholesterol, increasing the risk of heart disease. Women who smoke have heart attacks an average of 19 years earlier than nonsmoking women. No matter how long or how much you have smoked, you can immediately reduce your risk of heart attack by quitting.
- Increase your physical activity. Get at least 30 minutes of physical activity on most days of the week. Many studies have shown that exercise reduces the risk of heart attack and stroke, increases HDL (good) cholesterol levels, regulates glucose (blood sugar), lowers blood pressure, and increases the flexibility of arteries. All of these things help prevent heart attacks. Exercise has also been shown to reduce mental stress as well, another risk factor.
- Adopt a healthy diet that includes heart-healthy foods. Eat whole-grains, vegetables, and fruits. Choose lean meats and low-fat cheese and dairy products. Limit foods that have lots of saturated fat, like butter, whole milk, baked goods, ice cream, fatty meats, and cheese. Choose foods with less salt. Use spices, herbs, lemon, and lime instead of salt. This is really important if you have high blood pressure.
- Lose weight if you need to. Extra weight raises your risk for heart disease, especially for women. Where fat settles on the body is also an important predictor. Women who have a lot of fat around the waist are at greater risk than those who have fat around the hips. In the United States, about one third of women are classified as obese.
- Manage stress. Sometimes, people cope with stress by eating, drinking too much alcohol, or smoking. These can all hurt your heart. Lower your stress by talking to friends, staying physically active, meditating, and trying not to take on more than you can handle.
- Control cholesterol. If you have high cholesterol (above 200), talk to your doctor or nurse about losing weight and getting more active. Ask if there is medicine that may help. Before menopause, women in general have higher HDL ("good" cholesterol) levels in the blood. The higher a woman's HDL level, the less likely she is to have a heart attack. But after menopause, HDL levels tend to drop, increasing the risk of heart disease.
- Control blood pressure: High blood pressure, if left untreated, makes the heart work harder, and increases the risk of heart attack, stroke, and kidney failure.
- Get tested for diabetes, and if you have diabetes, keep your blood sugar levels under control. Diabetes is more common in women than men and poses a greater risk because it cancels the protective effects of estrogen in pre-menopausal women. Results of one study showed that women with diabetes have a higher risk of death from cardiovascular disease than men with diabetes have. Women with diabetes are also two to three times more likely to have a heart attack than women without diabetes.
- If you drink alcohol, don't have more than one drink per day. Too much alcohol can raise blood pressure, and contribute to obesity and heart failure.
- Take your medicine. If your doctor has prescribed medicine to lower your blood pressure or cholesterol, take it exactly as you have been told to.
- Get medical help for sleep problems. If you snore loudly, have been told you stop breathing at times when you sleep, and are very sleepy during the day, you may have sleep apnea. If you don't treat it, it raises your chances of having a heart attack or stroke. Talk with your doctor or nurse about treating this problem.
- Know the risks involved with oral contraceptives. Oral contraceptives (birth control pills) may pose an increased cardiovascular risk for women, especially those with other risk factors such as smoking. Researchers believe that birth control pills raise blood pressure and blood sugar levels in some women, as well as increase the risk of blood clots. The risks associated with birth control pills increase as women get older. Women should tell their doctors about any other cardiovascular risk factors they have before they begin taking birth control pills.
February is a great month to get started on a healthier heart-friendly lifestyle. A good first step is to find out your risk for heart disease. In February, the non-profit organization "Sister to Sister" will offer Women's Heart Health Fairs, with free heart disease screenings and "heart-healthy" prevention information and support to women in order to prevent heart disease. The screening includes:
- Risk assessment questionnaire
- Blood pressure check
- Body Mass Index (BMI)
- Family Health History
- Waist Circumference
Check the Sister to Sister website to see if you live near a city holding one of these events. http://www.sistertosister.org/fairs/2008_hhf.php
If you are unable to attend one of the events, ask your doctor for an assessment of your risk for heart disease.
For more information about women's heart health:
National Women's Health Information Center (NWHIC): (800) 994-9662
National Heart, Lung and Blood Institute: (800) 793-2665
The Heart Truth National Awareness Campaign for Women about Heart Disease
American Heart Association: (800) 793-2665
National Institutes of Health Women's Heart Disease information (includes many links)