Heart Disease In Women: Are You At Risk?

Ask almost any woman to describe a potential heart attack victim and the answer comes quickly and easily—an overweight man in his 60s or 70s who eats poorly, does no exercise, has high blood pressure, and maybe even smokes.

The shocking truth is that while this male sketch is indeed a prime candidate for heart disease, so is any post-menopausal woman describing him. Studies in the United States indicate that the risk of heart disease in women over the age of 65 approaches that of men. A fact that Dr. Cesar Recto II, president of the Philippine Heart Association, confirms: "Heart disease is not just a man’s disease. Women become more susceptible to heart disease after menopause."

Why is this? One of the primary reasons involves a natural decline in women’s HDL (high-density lipoprotein) or cardio-protective "good" cholesterol levels following menopause. HDL cholesterol is largely, but not exclusively, determined by a person’s genes. For women, the estrogen hormone also plays a role. Estrogen tends to raise a woman’s HDL, which is why young women have a lower risk of heart disease than men of similar age. After menopause, when estrogen levels drop, the risk of heart disease increases in women.

The good news is that there are ways for women to raise their HDL levels. While cholesterol drugs such as Lipitor, designed only to lower "bad" cholesterol or LDL (low-density lipoprotein) flood the market, drug companies are now turning their attention to the development of new medications to raise HDL levels. Stay tuned as drug manufacturers post their research results.

In the meantime, here are some ways to raise HDL naturally: exercise (30 to 60 minutes four to six times a week); lose weight if you are overweight; quit smoking; drink only one alcoholic beverage a day (red wine is particularly good for your heart); and eat foods with omega-3 fatty acids (such as fish). In addition, consume soluble fiber (oatmeal, beans, and brown rice) and follow a low-fat diet. Take a daily multivitamin and make sure that every calorie you consume has a nutritional benefit. Avoid all junk food, fast food, and trans fats! Go easy on the lechon and steer clear of innards. Be vigilant. It’s harder to increase HDL than to lower LDL—but doing both is essential to preventing heart disease.

Apart from reduced estrogen levels, other factors that put women at risk for heart disease include: high cholesterol (total cholesterol over 200 mg/dl), high blood pressure (over 120/80), family history of heart disease (a mother or sister with heart disease before 65), diabetes, obesity, and other illnesses. Controlling these factors at the earliest age possible is ideal. Hardening of the arteries starts in childhood, so a heart-healthy diet should start in the teen years.

If a woman has a heart attack, statistics show that she is more likely than a man to die within three years of that heart attack. Dr. Manuel ChuaChiaco, Jr., a cardio-vascular surgeon and chief of surgery at the Philippine Heart Center, confirms this with the following figures: "25% of men who suffer a heart attack will die within the first three years following their heart attack, and 50% of women will die."

Research is unclear why this is so. Some theories suggest that women’s hearts and arteries are smaller therefore more sensitive to blockage or damage. Or, a purely practical theory is that women do not take enough time to recuperate from cardiac episodes. They feel the need to take care of everybody else before themselves.

Many women do not seek quick medical attention at the onset of symptoms, or, even worse, they completely ignore them. My mother is a prime example. She felt mild chest pain while wallpapering her bathroom, but ignored it. She rationalized it as a pulled muscle. A few days later, she felt chest pain again and dialed 911. A rescue squad came, examined her, and wanted to take her to the hospital but she refused to go. She said that she felt better and that she would see her doctor that day, but she didn’t. Two days later, while my brother was visi ting her in New Hampshire, she had a heart attack at four o’clock in the morning, BUT she waited until five thirty to wake him up to drive her to the hospital because she didn’t want to disturb his sleep. My mother is lucky to be alive today.

Symptoms of a heart attack can differ for men and women. Both sexes often experience crushing chest pain, pain or discomfort in the upper body, such as the jaw, neck, arms and back, shortness of breath, breaking out in a cold sweat, nausea, or lightheadedness. In addition, some women may feel a burning sensation in their upper abdomen, severe vomiting, severe abnormal fatigue, or extreme lightheadedness. A woman may not even know she is having a heart attack and dismiss these common symptoms as indigestion or upset stomach. If you suspect that you may be having a heart attack, seek medical help immediately. Heart tissue starts to die within minutes of cardiac arrest, and the damage is irreversible.

Unfortunately, after being scared into a healthy diet and exercise program during her post-heart-attack-year of cardiac rehabilitation, my mother is back to her bad habits. Fried eggs and crispy bacon is still her favorite breakfast, and garlicky roast beef with creamy scalloped potatoes, her quintessential Sunday lunch. Yes, these things are yummy, but they are not worth dying for.

Prevention is the best cure. So, put down this newspaper and go for a walk.

Ms. Jones is the author of "Eating for Lower Cholesterol: A Balanced Approach to Heart Health with Recipes Everyone Will Love" available at National Book Store. She currently lives in Manila.