Thursday, June 7, 2007

Women and Heart Disease

Many women don’t worry about heart disease, or if they do, they are concerned it’s something the men in their lives might develop. But that attitude is a mistake.

While it’s true that estrogen gives women some protection against the disease, at least until menopause, heart disease is still the leading killer of American women. Here’s what women should watch for.

Keep heart disease at bay. First, because the disease is so prevalent, prevention is the key. Two major risk factors—obesity and smoking—are in your control. Padma Uppalapati, M.D., a cardiologist on the medical staff at Baylor Medical Center at Irving, says that women sometimes develop a cluster of conditions, including obesity, diabetes, high blood pressure, polycystic ovarian disease and depression that are linked with a high risk of heart disease. And while smoking is a risk factor for both men and women, it seems to affect women differently, she says.

Watch and test. Dr. Uppalapati recommends that all women at high risk for heart disease be tested, even if they don’t have any symptoms. That’s because symptoms in women can be more subtle than in men. “Women may have shortness of breath, feel tired, and maybe just have neck, jaw or upper back pain,” she explains. “It’s so common to hear women say, ‘I’m just not feeling well,’ with no additional symptoms.”

Search for signs. In women, a stress test with an EKG has a higher rate of false positives than in men, Dr. Uppalapati says. She recommends combining a stress test with an ultrasound, which can check for other heart problems such as mitral valve prolapse. She notes that with a good image from an ultrasound you shouldn’t need a nuclear scan, which sometimes returns a false positive in women due to a breast shadow.

Time to treat. Dr. Uppalapati warns that because women’s symptoms can be mild, they often postpone seeking treatment. Women need to get to the hospital early so the blockage can be cleared. “Time is extremely crucial,” she says. “It’s very important to get in early. Once women have angioplasty or bypass surgery they can do fine.”

Here are five ways women can lower their risk of heart disease:
1. Maintain a healthy weight.
2. Eat a balanced diet that helps keep cholesterol levels under control.
3. Exercise.
4. Don’t smoke.
5. Talk to your doctor about the pros and cons of hormone replacement therapy.

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