October 11, 2017
Many people have heard that cardiovascular disease is the leading cause of death in the United States. Cardiovascular disease comes in many forms, any of which may lead to a heart attack or stroke. What many do not know is that men and women often have different heart attack risk factors and warning signs.
According to the American Heart Association, “a heart attack strikes someone about every 43 seconds.”1 When a person experiences a heart attack, blood flow to the heart is completely blocked in one or more of the coronary arteries that supply the heart muscle. Chest pain is often considered the hallmark symptom of a heart attack, but not everyone having a heart attack experiences the same pain. In particular, women, the elderly, or people with diabetes may experience no pain, or atypical symptoms. In fact, some people experience a silent heart attack, where they experience no symptoms or symptoms that are difficult to recognize. As a result, they often believe that they have indigestion, the flu, or a strained muscle in their chest or upper back.
If you are a woman, understanding these different warning signs can save valuable time, and may make the difference between living and dying.
What Causes a Heart Attack?
Your heart is a constantly running pump and needs a constant source of oxygen and fuel. The oxygen is picked up in the blood and delivered to the heart muscle through blood vessels called arteries. Blockages in these coronary arteries slow or block the flow of blood to the hard working heart muscle. In a short period of time, the lack of blood flow causes heart muscle damage. If oxygen is restored quickly, long-term damage may be prevented. Continued lack of oxygen can cause significant damage to the heart, leading to disability or even death.
The most common cause of a heart attack is atherosclerosis or coronary artery disease (CAD). These conditions are caused when fatty deposits, called plaque, build up on the walls of the arteries. This build-up causes a narrowing of the arteries that restricts the blood flow. This plaque also can cause a tear or rupture in the artery, which leads to the formation of a blood clot. The blood clot can cause a sudden blockage in the blood flow in the artery.
How Heart Attack Symptoms Differ in Men and Women
When it comes to heart attack symptoms, men and women share several similarities. Similarities in symptoms include:
- Discomfort or pain in the center of the chest—many times, it feels like pressure or squeezing that may last a long time, or go away and come back.
- Discomfort or pain in the jaw, arms, back, neck, or stomach.
- Shortness of breath with or without chest pain.
- Cold sweat.
- Nausea or vomiting.
Women often have other, more subtle symptoms that may not be as obvious. While their most common symptom is chest pain or discomfort, women are more likely than their male counterparts to experience shortness of breath, nausea, and back or jaw pain. Other common symptoms in women include:
- Extreme fatigue, which can occur days or weeks in advance.
- Pressure or pain in the lower chest, upper abdomen, or upper back.
- Lightheadedness, which may lead to fainting.
Some of these symptoms can occur over hours, days, or weeks. If you feel these symptoms, do not wait more than 5 minutes to call 9-1-1. Even if you have a friend or relative with you, call for medical help rather than drive. If necessary, paramedics can start life-saving treatment on the way to the emergency room. This early care can determine how well you recover.
Know Your Risks
Many women believe that breast cancer is their biggest threat to good health. In fact, heart disease causes 6 times as many deaths in women as breast cancer. This makes heart disease the leading cause of death in both men and women.
There are several factors that increase your chance of having a heart attack. The more factors you have, the higher the risk of a heart attack. In men and women, these risk factors are the same. Uncontrollable risk factors are those you cannot change include:
- Increasing age.
- Race or ethnicity.
- Family history of cardiovascular disease.
- Previous heart attack.
Controllable risk factors are those that can be modified by lifestyle changes and/or medications. These are:
- Smoking or exposure to secondhand smoke.
- High blood pressure.
- High cholesterol.
- Sedentary lifestyle.
Other factors that are specific to women include:
- Younger age at menopause.
- Hormonal replacement therapy (HRT).
- Use of birth control pills, especially in heavy smokers.
Before menopause, women have a slightly lower risk of heart attack than men. However, postmenopausal women have a similar risk for heart attack as men. Other disparities between men and women having heart attacks are: 2
- Women aged 45 or younger are more likely than men to die within a year of their first heart attack.
- Only 65 percent of women said the first thing they would do if they thought they were having a heart attack was to call 9-1-1.
- Men are 2 to 3 times more likely than women to receive an implantable defibrillator for the prevention of sudden cardiac death.
- Previous studies and clinical trials have often been done with inadequate numbers of women in the study population, representing just 38 percent of subjects.
- In addition, 3/4 of cardiovascular clinical trials do not report sex-specific results, making it difficult for researchers and clinicians to draw conclusions about their effects on women.
Changes You Can Make to Prevent a Heart Attack
To help reduce your chances of a heart attack, take these steps to modify your lifestyle:
- If you smoke, quit—Talk to your doctor about smoking cessation programs. There are nicotine replacement products to help kick the habit.
- Exercise regularly:
- Aim for 150 minutes of exercise each week, about 30 minutes on most days.
- Activity should be moderate intensity, like walking or swimming. You also can do 75 minutes per week of vigorous exercise, such as running or participating in an exercise class.
- Do strength training twice a week.
- Remember to talk to your doctor before starting a new exercise routine.
- Eat healthy foods:
- Eat more fruits and vegetables, whole grains and high-fiber foods.
- Try to eat fish twice a week.
- Avoid foods that are high in trans fats, saturated fats, sodium, cholesterol, and sugar.
- Maintain a healthy weight—If you are overweight, talk to your doctor about ways you can lose weight and keep it off. Two main strategies are to exercise and to reduce the number of calories you consume. A dietician can be helpful with meal planning.
In addition to lifestyle changes, you need to monitor and take care of other health conditions:
- Stay active in a cardiac rehab program specifically designed for you following a heart attack, stroke, or heart surgery. The program will help you recover and may lower your risk of having another event.
- Control any health conditions you have by taking all medications as prescribed, and by following the lifestyle changes listed above.
- Take steps to relax and reduce stress, such as yoga or meditation.
- Go to any recommended doctor's appointments.
- Talk with your doctor about taking aspirin every day.
Change is not always easy, so start slowly. The more risk factors you control, the better chance you have to ward off a heart attack. Talk with your doctor about the best course of action for you. Take the time to learn the signs of a heart attack in women, and do not be afraid to call for emergency medical services.
1American Heart Association: www.heart.org
2Go Red for Women: www.goredforwomen.org