The Medical Minute: Women and heart disease

February 18, 2004

By John Messmer, M.D.
Penn State Milton S. Hershey Medical Center

If you are a woman, what disease scares you the most? Breast cancer? You've probably heard the somewhat misleading statistic that one in nine women will have breast cancer in her lifetime. You may be religious about getting your annual mammogram for that reason. Maybe you're more concerned about cervical cancer, which is detected by a Pap smear. Or perhaps Alzheimer's disease worries you most, particularly if you are getting older. With the onset of age, you may also focus on concerns about osteoporosis.

If you were going to work on lowering the risk of the most important health threat you face, however, you should choose heart disease.

Consider these statistics: One in 22 American women has heart disease at any time compared to one in 1,326 for breast cancer, one in about 11,000 for cancer of the cervix, and about one in 33 for Alzheimer's in women between 65 and 74. As called to attention by the national Red Dress project, heart disease is by far the number one killer of women in the United States.

When we think of heart disease, we often think of it as a disease that primarily affects men. That's because women do not typically get the classic symptom of angina that men do. Women more commonly experience fatigue, breathlessness, or a pain that is not the same as men. Women tend to be about 10 years older than men when they first get symptoms. So, it's commonly not something people, including physicians, think about when a woman with risk factors presents for an evaluation.

Controlling risk factors dramatically reduces the occurrence of heart disease in men and women. The most important one is smoking. A smoker's risk of heart disease is four to seven times higher than a non-smoker. Those exposed to second-hand smoke increase their risk by one-third. A one-pack-per-day smoker who also uses birth control pills increases her risk 20 times. High blood pressure increases risk by three to four times, diabetes gives an eight-fold increased risk, and lack of exercise adds another 30 percent. More than half of women over 55 should lower their cholesterol and two in three women (just like men) are heavy enough to be considered obese or overweight.

The good news is most heart disease is preventable. One might point out that with many impressive advances in treatment of heart disease, we may be able to rely on technology to overcome our excesses. Even though heart disease treatment continues to improve, it saves lives, not good health. Cardiovascular disease is a multi-system problem -- it affects all organs, not just the heart. Angioplasty, coronary bypass, heart pumps and transplants may keep you going, but meanwhile your brain, kidneys and other areas continue to deteriorate.

Add to that the cost -- one-fifth of the one trillion dollars spent on health care in the United States is spent on heart disease. In a perfect world, that means your health insurance cost could be reduced by 20 percent, and we could provide medical care to all uninsured Americans if we simply could eliminate all preventable heart disease.

Here's the best news: most of us can reduce or eliminate our risk of heart disease without medication. Quit smoking today -- your risk will be cut in half in a year. Exercise for 30 minutes four times a week -- every week, not just in nice weather -- and you will cut your risk in half again. Adjust your eating habits so you achieve and maintain a normal weight, and stop adding salt to your food. These actions will reduce your risk of diabetes, high cholesterol and high blood pressure.

You don't even have to visit the doctor to eliminate most of your cardiovascular risks. If you do visit your doctor to help control your blood pressure and cholesterol, your risk could be even lower. Not only that, but you will feel better, have more energy and look good too.

Remember, heart disease is the number one killer of women and is preventable. Make this your year for good heart health.

(Media Contacts)

Last Updated March 19, 2009