If you had chest pains, you\u2019d probably guess right away you were having a heart attack. But what if your symptoms were fatigue, jaw pain or even nausea \u2013 would you know they might signal a cardiac emergency? Would your doctor?<\/p>\n
That\u2019s just one of the major differences in the symptoms of heart disease between men and women.<\/p>\n
To get the facts on heart disease in women, we talked with leading cardiologist C. Noel Bairey Merz, M.D. She\u2019s director of the Women\u2019s Heart Center at Cedars-Sinai Medical Center in Los Angeles, which leads cutting-edge research on gender differences in cardiovascular disease.<\/p>\n
In this exclusive Lifescript interview, Bairey Merz discusses the new realities of heart disease in women, how women\u2019s risk factors have changed over the years, and the best ways to live a heart-healthy lifestyle.<\/p>\n
What\u2019s the top myth about heart disease in women?
The biggest myth is that only elderly women get heart disease, and young women are protected. In reality, heart disease kills more young women \u2013 even 20- to 25-year-olds \u2013 than breast cancer.<\/p>\n
It\u2019s also the leading killer of midlife women, ages 45-65, and older women too.<\/p>\n
Why is there so much misinformation on the subject?
When heart disease was first studied in the 1950s, it was identified as something that killed middle-aged men \u2026 and it\u2019s true that, at that time, more men died than women.<\/p>\n
But demographic trends have changed. Now, more women die than men [because warning signs are not recognized]. Still, medical schools continue to teach that it\u2019s predominantly a male disease.<\/p>\n
The other problem is that women often present different heart attack symptoms. Women themselves will under-recognize signs, just like physicians, because we\u2019re all tutored to [recognize] a male pattern.<\/p>\n
What are the differences in symptoms of heart disease?
About two-thirds of men will present with what we call the \u201cHollywood heart attack\u201d \u2013 typically, pain or pressure in the middle of the chest. It might radiate to the jaw or arm, with some shortness of breath, perhaps some nausea.<\/p>\n
Women\u2019s symptoms might just be jaw or elbow pain, stomach upset or indigestion. It might only be some shortness of breath or a sense of overwhelming fatigue.<\/p>\n
[These other symptoms] can arise in women at least half the time. Even some men will present [them].<\/p>\n
Are these intense sensations?
Not necessarily \u2013 that\u2019s what\u2019s unnerving.<\/p>\n
You need to [know] what\u2019s typical for you. If you always get heartburn and indigestion after eating Dodger Dogs, I don\u2019t want to hear about it at 2 a.m., because it\u2019s probably not a heart attack.<\/p>\n
But if this isn\u2019t typical, if you don\u2019t have any good reason to be up at 2 a.m. but you\u2019re having indigestion and are a little sweaty \u2013 and it doesn\u2019t feel like the flu and you don\u2019t have a fever \u2013 go to the emergency room. It might be a heart attack.<\/p>\n
What does the latest research show about symptoms of heart disease in women?
We\u2019ve uncovered something called microvascular coronary dysfunction. Women present with persistent, sometimes disabling chest discomfort. They have an abnormal stress test, but when they have an angiogram, [it shows] the arteries are open.<\/p>\n
We really put this on the radar as something that takes lives \u2013 and it\u2019s more prevalent in women. We\u2019re doing studies on the best ways to diagnose and treat it.<\/p>\n
If doctors aren\u2019t aware of this, what should a woman do if her symptoms are being dismissed?
If a woman is told by her physician or cardiologist that it\u2019s \u201call in her head\u201d \u2013 that it must be her gallbladder or stomach, or she\u2019s hysterical \u2013 it is possible that she has microvascular coronary dysfunction. She should seek a health-care provider who\u2019s willing to entertain that thought, or go to a high-quality women\u2019s heart center. [Here\u2019s a list of Women\u2019s Heart Centers around the country.]<\/p>\n
What are the major causes of heart disease in women?
There are five traditional risk factors: cigarette smoking, high blood pressure, high cholesterol, diabetes and family history \u2013 that is, a close relative who had cardiovascular disease (including heart attack, stroke, angioplasty or bypass) before age 60.<\/p>\n
How have women\u2019s risk factors changed over the years?
In the 1950s, it was uncommon for women to smoke cigarettes \u2013 and if they did, they didn\u2019t smoke a pack a day. Now, women smoke just as much as men and it\u2019s just as big a risk factor. If you smoke cigarettes, expect to have a heart attack or stroke.<\/p>\n
The other thing is the aging of America. Heart disease is a chronic disease \u2013 most of us will get it if we live long enough. And women, on average, live 6-8 years longer than men.<\/p>\n
If women want to live a heart-healthy lifestyle, what are the most important things they can do?
Follow these guidelines:<\/p>\n
1. Avoid smoking and breathing other people\u2019s smoke, which are major causes of heart disease. Nobody should smoke in your home, particularly if you have children there.<\/p>\n
2. Do some physical activity for 30 minutes a day. It doesn\u2019t have to be a specific aerobic exercise, or huffing and puffing at the gym. You just need to move your body through space. It also doesn\u2019t have to be done consecutively. It could be intermittent stair-climbing if you work in an office.<\/p>\n
3. Eat a heart-healthy diet. Mediterranean-style eating works for women and men \u2013 but that doesn\u2019t mean having huge bowls of pasta or drinking a cup of olive oil every day.<\/p>\n
It means eating 9-10 servings of fruit or vegetables per day, even though the average American has two servings. A serving is about what you can hold in your hand.<\/p>\n
You also want complex carbohydrates \u2013 mostly beans and legumes, along with whole grains. Potatoes are OK, occasionally.<\/p>\n
Eat fish once or twice a week \u2013 the size of your palm or a deck of cards. When you eat [meat], it should be in condiment portions \u2013 don\u2019t sit down and eat one of those massive chicken breasts.<\/p>\n
At the very top of the Mediterranean food pyramid is the occasional dessert \u2013 not every day.<\/p>\n
4. Avoid being obese, which is defined as 20% over your ideal body weight. Just being overweight doesn\u2019t seem to count for very much [added risk], especially if you exercise every day.<\/p>\n
5. Last \u2013 and my personal favorite \u2013 is a single serving [4-5 ounces] of alcohol with a meal. It\u2019s associated with longevity as well as a lower risk of heart disease.<\/p>\n
That doesn\u2019t mean seven drinks on Saturday night, or drinking at the bar while eating nuts.<\/p>\n
And, obviously, this isn\u2019t a medical advisement. Check with your own health-care provider about whether it\u2019s reasonable for you.<\/p>\n
How much impact do these habits have on cardiovascular risk?
There\u2019s very relevant research on humans demonstrating this is how we should conduct our lives.<\/p>\n
Among the populations that have these five health habits \u2013 and less than 10% are Americans \u2013 there\u2019s an 80% reduced lifetime risk of cardiovascular disease.<\/p>\n
How protective is HDL (\u201cgood\u201d) cholesterol against the causes of heart disease?
I often hear from patients and even primary-care physicians that women with high HDL could never have a heart attack \u2026 that they\u2019re protected even if their [total] cholesterol is high, they smoke, they\u2019re overweight and have high blood pressure. That\u2019s a huge myth.<\/p>\n
I wish I had $100 for every woman I\u2019ve cared for with high HDL who had a heart attack.<\/p>\n
If a woman has heart disease, what medications are most effective?
For the 6 million women in the U.S. who have the traditional obstructive coronary disease, they should follow the same risk-reduction strategies as men.<\/p>\n<\/div>\n
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Do you understand the causes and symptoms of heart disease in women? Probably not \u2013 and what you don\u2019t know could hurt you, says renowned cardiologist C<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":{"0":"post-385086","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-business"},"yoast_head":"\n