Women’s Health

Cardiovascular Disease & Stroke

Heart disease is by far the major cause of death for women in the United States. We’ve already noted that breast cancer is responsible for 40,000 deaths in the US each year. Consider this—heart disease is responsible for 489,000 deaths in the U.S. each year. Strokes, which have many of the same risk factors of heart disease, are responsible for another 100,000 deaths in women each year. The table below lists the major causes of death in the U.S. for year for the year 2000 – just in women.

Heart Disease 489,000
Strokes 110,000
Lung Cancer 79,560
Breast Cancer 40,410
Ovarian Cancer 16,210
Uterine Cancer 7,310
Cervical Cancer 3,710

Most studies reveal that women have a far different perception. In one major U.S. Study published the Archives of Family Medicine (Volume 9, No. 6, June 2000) by Mosca L, Jones WK et al. only 8% of women identified heart disease and strokes as their greatest risk of mortality despite the fact that over 50% of women will die of heart disease and strokes.

According to the Department of Health and Human Services one in three women dies of heart disease alone while one in 30 women die of breast cancer. In an AHA (American Heart Association Study (2005) only 55% of women are aware that heart disease is the leading cause of death among women while only 20% of women identified heart disease as the greatest health problem facing women today.

So the bottom line is this—for most women visiting their gynecologist for a routine annual exam and are not having gynecologic problems it may be more worthwhile to discuss your risks for heart disease and strokes than your risk of cervical, uterine, breast and ovarian cancer. And the reason is simple—the average woman is at far great risk for heart disease and strokes than those 4 cancers combined!

What are the risk factors for heart disease and strokes?

Both heart disease and strokes are related inasmuch as both are diseases of small to medium sized blood vessels. With most forms of heart disease the coronary arteries that supply the heart muscle are narrowed. With most forms of “stroke” it is the small and medium sized blood vessels to the brain that are similarly affected. These vessels become clogged with plaque and don’t allow blood to flow freely and carry oxygen to these vital organs.

We know that there are certain risk factors—some of them we can manage while others are beyond our control. We’ll start with those factors that you can’t modify or control:

  • Advancing age—83% of people who die of coronary artery disease are over 65.
  • Gender—women are at lower risk than men. You picked the right gender!
  • Family history—if you have a strong family history of cardiovascular disease—first degree relatives (parents or siblings) who were younger than 50 when they were diagnosed—your risk is increased
  • Race—African Americans have a higher risk of hypertension and diabetes compared to caucasians. Now for the risks you can modify and control
  • Hypertension—In addition to increasing your risk of heart disease and strokes, hypertension also increases your risk for congestive heart failure and renal failure.
  • Abnormally high blood lipids (cholesterol and triglycerides)—this includes LDL cholesterol (“bad cholesterol”) as well as another common lipid (or fat) call triglycerides.
  • Obesity—Women who have excess weight, especially around their waist, are more likely to develop heart disease and strokes even if they have no other risk factors. Excess weight causes an increased work load on the heart, lowers good cholesterol and raises bad cholesterol and triglycerides. Being overweight also increases your blood pressure.
  • Smoking—In general, smokers have 2-4 times the risk of cardiac disease compared with non-smokers.
  • Physical inactivity—Regular moderate to intense exercise reduces your risk of heart disease, strokes and diabetes. Exercise also helps to lower your cholesterol.
  • Diabetes—About 75% of diabetics will die of some form of blood vessel disease—heart attacks, strokes and kidney failure. Even well-controlled diabetics have a markedly increased risk for developing heart disease and strokes.
  • Stress—Stress produces many deleterious effects on one’s health. People under stress are more likely to sleep poorly, overeat and not exercise. The long term effects of stress are profound and beyond the scope of this brief discussion.
  • Excessive alcohol consumption—Alcohol, in excess, can raise blood pressure, contribute to elevated triglycerides, obesity and abnormal heart rhythms.

Where can I read more about heart disease in women?

www.familydoctor.org/287.xml

www.womenheart.org/

www.americanheart.org/