Why is Heart Disease the #1 Killer of Women?

The statistics we hear are true: Heart disease is the number one killer of women. The question is, why? Have doctors been indifferent to women? Horrors, no. Here is the answer:

Heart disease never used to be such a big killer of women because other things got to them first. Now people live longer - and unlike men, women's hearts are protected by their hormones until menopause (estrogen enormously raises HDL, the good cholesterol). After menopause, until a generation ago, other diseases were the common killers of women: cancer, smoking-related diseases, infections like pneumonia, appendicitis, & gall bladder disease, which was common.

Plus most people smoked. Until the surgeon general’s warning in 1964,  men in their 40s & 50s were dropping like flies from smoking's effects, and no one knew the medical connection. Those already addicted usually continued to smoke, but women got away with it because their hormones protected them until menopause. So the old idea persisted among physicians that women didn't get heart disease.

Now we're living longer, and putting on weight. Junk food which never existed now does; trans fats & saturated fats are still clogging our arteries, and each pound gained is an extra load for the heart. Men arriving in E.R.s complaining of heart attack symptoms get treated aggressively, women less aggressively because womens’ symptoms are often different from men’s. Or women dismiss their symptoms as "just a stomach ache," or "I feel faint, think I'll lie down." This compounds the problem, since many women show up in emergency rooms after heart damage has already occurred.

From the Mayo Clinic:

GENERAL HEART ATTACK SYMPTOMS and What to do

View too:

Women, Heart Disease, & Stroke

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Why Younger Plaque is More Dangerous

Women's heart symptoms differ from men

Cardiovascular disease symptoms often different for women than they are for men, but just as serious

From the Chicago Sun Times, February 3, 2010

BY LORI RACKL Staff Reporter

Susan Fessler was on the evening train when she experienced a "funny, sickening pain" in her jaw. Then more pain radiated down her left arm.

Fessler remembers feeling especially exhausted that January night, even taking an uncharacteristic nap during the commute home.

"It was unnerving," said the executive assistant and mother of three, who was 45 years old at the time. "I called my husband from the train and told him I didn't feel good."

Her husband rushed her to the hospital, where doctors spent the next two days running tests. The doctors chalked up her symptoms to acid reflux and sent her on her way.

One year later, Fessler had a massive heart attack and nearly died.

Cardiovascular disease claims more lives than the next five leading causes of death combined, including all forms of cancer. Consider this: One in 30 American women will die of breast cancer. About one in three will die from cardiovascular disease.

What doctors now know is that female heart-attack patients are more likely than men to experience symptoms other than the classic chest pain, such as shortness of breath, exhaustion and pain in the jaw, neck or stomach. Women also tend to develop heart disease later in life -- about 10 years after men, whose symptoms generally start showing up in their 40s.

Educating women about these gender differences and cardiovascular disease in general is a huge component of the Go Red campaign. The Web site GoRedForWomen.org helps them assess their personal risk for heart disease and includes a 12-week nutrition and fitness program modeled on a heart-healthy lifestyle.

The good news is that cardiovascular deaths among both women and men are on the decline. But experts worry the large number who are obese or have diabetes could reverse that trend.

Recent research also suggests a narrowing of the gender gap that traditionally saw much poorer survival rates for female heart-attack victims. The Archives of Internal Medicine published a study in October that found in-hospital survival rates improved for both genders over the last decade, but women -- especially those younger than 55 -- posted bigger progress in this area than men.

Improvements like this "indicate that we are on the right track," according to an accompanying editorial in the journal. But there's more work to be done.

"Men are still believed to be at greater risk for heart attack and stroke and are thus more aggressively informed, counseled and treated for these diseases," the editorial said.

That disparity aggravates women like Fessler. "You feel like you go to the doctor as a woman, and they write it off as stress or reflux," said Fessler, who has nine stents propping open her arteries. She's on a medicine cabinet's worth of drugs to treat her heart disease, but overall she feels "pretty good." And pretty lucky.

"I almost didn't go to the hospital the night I had my heart attack," she said. "My advice: If you have a feeling in the pit of your stomach that something's not right, it's probably not. Don't ignore what your body is telling you. Listen to it."

Susan Fessler was on the train home when she felt heart disease symptoms. After two days of hospital tests, she was sent home. One year later, she had a massive heart attack.

(Scott Stewart/Sun-Times)

Heart attack & Stroke Warning Signs