Baseline Medical

Heart Disease Risks In Women Bethlehem

Research is identifying gender differences in heart disease that may help fine-tune prevention, diagnosis, and treatment in women. Here are some examples.

Blood lipids. Before menopause, a woman's own estrogen helps protect her from heart disease by increasing HDL (good) cholesterol and decreasing LDL (bad) cholesterol. After menopause, women have higher concentrations of total cholesterol than men do. But this alone doesn't explain the sudden rise in heart disease risk after menopause. Elevated triglycerides are an especially powerful contributor to cardiovascular risk in women. Low HDL and high triglycerides appear to be the only factors that increase the risk of death from heart disease in women over age 65.

Diabetes. Diabetes increases the risk of heart disease in women more than it does in men, perhaps because women with diabetes more often have added risk factors, such as obesity, hypertension, and high cholesterol. Although women usually develop heart disease about 10 years later than men, diabetes erases that advantage. In women who've already had a heart attack, diabetes doubles the risk for a second heart attack and increases the risk for heart failure.

Metabolic syndrome. This is a group of health risks - large waist size, elevated blood pressure, glucose intolerance, low HDL cholesterol, and high triglycerides - that increases your chance of developing heart disease, stroke, and diabetes. Harvard Medical School research suggests that, for women, metabolic syndrome is the most important risk factor for having heart attacks at an unusually early age. In a study of patients undergoing bypass surgery, metabolic syndrome produced a greater risk for women than it did for men of dying within eight years.

Smoking. 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. Moreover, women may not find nicotine replacement as effective, and - because the menstrual cycle affects tobacco withdrawal symptoms - they may get inconsistent results with antismoking medications.

Symptoms. Many women don't experience the crushing chest pain that is a classic symptom of a heart attack in men. Some feel extremely tired or short of breath. Other atypical symptoms include nausea and abdominal, neck, and shoulder pain. In one study, women reported deep fatigue and disturbed sleep as much as a month or two before a heart attack. During a heart attack, only about one in eight women reported chest pain; even then, they described it as pressure, aching, or tightness rather than pain.

Diagnosis and treatment. Women have smaller and lighter coronary arteries than men do. This makes angiography, angioplasty, and coronary bypass surgery more difficult to do, thereby reducing a woman's chance of receiving a proper diagnosis and having a good outcome. Women tend to have more complications following surgery. And they're twice as likely to continue having symptoms several years after coronary angioplasty. (They're usually older than men and have more chronic conditions at the time of their first coronary event.) Women's responses to standard exercise stress tests are also different from men's, so it's difficult to interpret the results. Fortunately, these problems are diminishing thanks to advances in technology and better understanding of heart disease in women.

Baseline Medical features a 10 minute non-invasive vascular ultrasound exam of the carotid arteries in the neck to learn about individual's risk for heart disease and stroke. Serious disease can be diagnosed and treated before it is a life-changing health issue.