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Heart disease and women

CAD - women; Coronary artery disease - women

Information

People often DO NOT consider heart disease a woman's disease. Yet cardiovascular disease is the leading killer of women over age 25. It kills nearly twice as many women in the United States as all types of cancer.

Men have a greater risk for heart disease earlier in life than women. Women's risk increases after menopause.

EARLY HEART DISEASE SIGNS

Women may have warning signs that go unnoticed for weeks or even years before a heart attack occurs.

  • Men most often have the "classic" heart attack signs: tightness in the chest, arm pain, and shortness of breath.
  • Women's symptoms can resemble those of men.
  • Women may also complain of other symptoms, such as nausea, fatigue, indigestion, anxiety, and dizziness.

ACT IN TIME

Recognizing and treating a heart attack right away improves your chance for survival. On average, a person having a heart attack will wait for 2 hours before calling for help.

Know the warning signs and always call 911 or the local emergency number within 5 minutes of when symptoms begin. By acting quickly, you can limit damage to your heart.

MANAGE YOUR RISK FACTORS

A risk factor is something that increases your chance of getting a disease or having a certain health condition. You can change some risk factors for heart disease. Other risk factors you cannot change.

Women should work with their health care provider to address risk factors they can change.

  • Use lifestyle measures to keep your blood cholesterol levels in the right range. Targets for cholesterol levels vary, depending on your risk factors. Ask your provider which targets are best for you.
  • Keep your blood pressure in a healthy range. Your ideal blood pressure level will depend on your risk factors. Discuss your target blood pressure with your provider.

Estrogen is no longer used to prevent heart disease in women of any age. Estrogen may increase the risk of heart disease for older women. However, it may still be used for some women to treat hot flashes or other medical problems.

  • Estrogen use is probably safest for women under age 60.
  • It should be used for the shortest possible period of time.
  • Only women who have a low risk for stroke, heart disease, blood clots, or breast cancer should take estrogen.

Some women (especially those with heart disease) can take a low-dose aspirin daily to help prevent heart attacks. Some women will be advised to take low-dose aspirin to prevent stroke. Aspirin can increase the risk for bleeding, so check with your provider before beginning daily aspirin treatment.

LIVE A HEALTHY LIFESTYLE

Some of the risk factors for heart disease that you CAN change are:

  • DO NOT smoke or use tobacco.
  • Get plenty of exercise. Women who need to lose weight or maintain their weight should get at least 60 to 90 minutes of moderate-intensity exercise on most days. To maintain your health, get at least 30 minutes of exercise a day, preferably at least 5 days a week.
  • Maintain a healthy weight. Women should strive for a body mass index (BMI) of between 18.5 and 24.9 and a waist smaller than 35 inches (90 cm).
  • Get checked and treated for depression, if necessary.
  • Women with high cholesterol or triglyceride levels may benefit from omega-3 fatty acid supplements.

If you drink alcohol, limit yourself to no more than one drink per day. DO NOT drink just for the purpose of protecting your heart.

Good nutrition is important to your heart health, and it will help control some of your heart disease risk factors.

  • Eat a diet that is rich in fruits, vegetables, and whole grains.
  • Choose lean proteins, such as chicken, fish, beans, and legumes.
  • Eat low-fat dairy products, such as skim milk and low-fat yogurt.
  • Avoid sodium (salt) and fats found in fried foods, processed foods, and baked goods.
  • Eat fewer animal products that contain cheese, cream, or eggs.
  • Read labels, and stay away from "saturated fat" and anything that contains "partially-hydrogenated" or "hydrogenated" fats. These products are most often high in unhealthy fats.

References

Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e596-e646. PMID: 30879355 www.ncbi.nlm.nih.gov/pubmed/30879355.

Chandrasekhar J, Mehran R. Heart disease in women. In: Levine GN, ed. Cardiology Secrets. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 52.

Gulati M, Bairey Merz CN. Cardiovascular disease in women. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 89.

Hodis HN, Mack WJ, Henderson VW, et al; ELITE Research Group. Vascular effects of early versus late postmenopausal treatment with estradiol. N Engl J Med. 2016;374(13):1221-1231. PMID: 27028912 www.ncbi.nlm.nih.gov/pubmed/27028912.

Mehta LS, Beckie TM, DeVon HA, et al. Acute myocardial infarction in women: a scientific statement from the American Heart Association. Circulation. 2016;133(9):916-947 PMID: 26811316 www.ncbi.nlm.nih.gov/pubmed/26811316.

NAMS Hormone Therapy Position Statement Advisory Panel, The. 2017 hormone therapy position statement of The North American Menopause Society. Menopause. 2017;24(7):728-753. PMID: 28650869 www.ncbi.nlm.nih.gov/pubmed/28650869.

Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 45. 

  • Chest pain

    Chest pain

    Animation

  •  

    Chest pain - Animation

    When people have chest pain, they're often concerned they're having a heart attack. I'm Dr. Alan Greene and I'd like to talk to you for a moment about the different kinds of chest pain and when it may be an emergency. It turns out, there are lots of different kinds of chest pain. In fact, almost everything in the chest can hurt in one way or another. Some of the causes are really nothing more than a minor inconvenience. Some of them though are quite serious, even life threatening. You can have chest pain sure from the heart, but also from pneumonia. You can have chest pain from asthma. You can have chest pain from a blood clot in the lungs. It can be from nothing more than a strain of some of the muscles between the ribs, or nerves. You can also have chest pain that comes from acid reflux of from a stomach ulcer, gallstones. Many, many things can cause chest pain. You want to call 911 if you are having sudden, crushing chest pain or if your chest pain radiates into the jaw or the left arm. You want to call 911 if your chest pain also causes shortness of breath, or dizziness, nausea, or vomiting. You want to call 911 if you know you have heart disease and you do occasionally have pain but your pain is getting significantly worse than it is ordinarily. Or comes on with less activity than it does otherwise. But whatever the cause of chest pain, unless you're sure what's causing it, it's worth contacting your physician to find out what may be going on. It's not a symptom to ignore.

  • Coronary artery disease (CAD) overview

    Coronary artery disease (CAD) overview

    Animation

  •  

    Coronary artery disease (CAD) overview - Animation

    A look at coronary artery disease (CAD) including causes, symptoms, health risks, and treatment.

  • Heart disease modifiable risk factors - obesity

    Heart disease modifiable risk factors - obesity

    Animation

  •  

    Heart disease modifiable risk factors - obesity - Animation

    How reducing your weight can help decrease risk of heart disease.

  • Heart - section through the middle

    Heart - section through the middle - illustration

    The interior of the heart is composed of valves, chambers, and associated vessels.

    Heart - section through the middle

    illustration

  • Heart - front view

    Heart - front view - illustration

    The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.

    Heart - front view

    illustration

  • Acute MI

    Acute MI - illustration

    A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.

    Acute MI

    illustration

  • Healthy diet

    Healthy diet - illustration

    For a healthy diet, replace unhealthy and fattening foods with healthier alternatives, such as fresh fruits and vegetables.

    Healthy diet

    illustration

  • Chest pain

    Animation

  •  

    Chest pain - Animation

    When people have chest pain, they're often concerned they're having a heart attack. I'm Dr. Alan Greene and I'd like to talk to you for a moment about the different kinds of chest pain and when it may be an emergency. It turns out, there are lots of different kinds of chest pain. In fact, almost everything in the chest can hurt in one way or another. Some of the causes are really nothing more than a minor inconvenience. Some of them though are quite serious, even life threatening. You can have chest pain sure from the heart, but also from pneumonia. You can have chest pain from asthma. You can have chest pain from a blood clot in the lungs. It can be from nothing more than a strain of some of the muscles between the ribs, or nerves. You can also have chest pain that comes from acid reflux of from a stomach ulcer, gallstones. Many, many things can cause chest pain. You want to call 911 if you are having sudden, crushing chest pain or if your chest pain radiates into the jaw or the left arm. You want to call 911 if your chest pain also causes shortness of breath, or dizziness, nausea, or vomiting. You want to call 911 if you know you have heart disease and you do occasionally have pain but your pain is getting significantly worse than it is ordinarily. Or comes on with less activity than it does otherwise. But whatever the cause of chest pain, unless you're sure what's causing it, it's worth contacting your physician to find out what may be going on. It's not a symptom to ignore.

  • Coronary artery disease (CAD) overview

    Animation

  •  

    Coronary artery disease (CAD) overview - Animation

    A look at coronary artery disease (CAD) including causes, symptoms, health risks, and treatment.

  • Heart disease modifiable risk factors - obesity

    Animation

  •  

    Heart disease modifiable risk factors - obesity - Animation

    How reducing your weight can help decrease risk of heart disease.

  • Heart - section through the middle

    Heart - section through the middle - illustration

    The interior of the heart is composed of valves, chambers, and associated vessels.

    Heart - section through the middle

    illustration

  • Heart - front view

    Heart - front view - illustration

    The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.

    Heart - front view

    illustration

  • Acute MI

    Acute MI - illustration

    A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.

    Acute MI

    illustration

  • Healthy diet

    Healthy diet - illustration

    For a healthy diet, replace unhealthy and fattening foods with healthier alternatives, such as fresh fruits and vegetables.

    Healthy diet

    illustration

A Closer Look

 

Self Care

 

Tests for Heart disease and women

 
 

Review Date: 6/18/2018

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Internal review and update on 10/18/2019 by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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