Studies Show a Woman Diagnosed with Heart Disease is More Likely to Die Than a Man,
a Cardiologist Explains Why

Traditional risk factors such as high cholesterol, high blood pressure and obesity affect women and men, but other factors may play a bigger role in the development of heart disease in women. In order to also help increase awareness of heart disease, understanding what constitutes higher risk for coronary artery is important so these women can be identified early and followed closely. In general, women have the same classic risk factors for developing coronary artery disease as men. However, some risk factors may affect women differently than men. For example, diabetes raises the risk of coronary artery disease more in women. Perhaps this is because women with diabetes more often have added risk factors, like obesity, hypertension and high cholesterol. Although women typically develop heart disease ten years later than men, diabetes erases that advantage. Women who smoke are twice as likely to have a heart attack as male smokers. Women are also less likely to succeed in quitting and women who do quit are more likely to start again. The use of birth control pills can increase the risk for the development of coronary disease, especially in women older than thirty-five years. Women who smoke and take birth control pills are at a much higher risk and these pills should be discontinued in women who smoke.

In addition to an atypical presentation of a heart attack, about 10% of women who experience a heart attack have no obvious blockages seen on cardiac catheterization. This is a substantially higher percentage than in men. Women are much more likely to develop certain conditions such as coronary vasospasm, which is a temporary tightening of the muscle wall of the coronary arteries that with time can lead to a heart attack. Spontaneous coronary dissection (SCAD) is an uncommon occurrence that develops when a tear forms in one of the main coronary arteries or the smaller branches. This dissection can disrupt blood flow to the heart causing a heart attack and sudden death. It most commonly occurs in healthy women in their 40s and this condition needs to be diagnosed and treated quickly. The broken heart syndrome or takotsubo cardiomyopathy occurs 90 percent of the time in women and is often brought on by stressful situations that can cause severe, but usually temporary, heart muscle failure.

Increased awareness and early detection of risk factors and presentation of heart disease are very important but prevention of heart disease in women can perhaps have the biggest impact. Smoking cessation is critical. Your chance of a heart attack doubles if you smoke one or more cigarettes a day. A healthy diet of whole grains, fruits and vegetables, and poly and monounsaturated fats are key as well as daily exercise and stress management. It is important to “Know your numbers,” maintaining weight, cholesterol and blood pressure at appropriate levels.  Most importantly be proactive about your health. Discuss your cardiac risk with your doctor and the appropriateness of certain testing such as calcium score and CT scans of the heart, stress testing and other imaging modalities. Being your own advocate can save your life!


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