HealthSmarts: Heart-Risk Signs for Women

By DR. TASNEEM BHATIA

She could be your next-door neighbor. She could be your mother, your sister or your daughter. She could be one of thousands of young women in this country unaware of their risk for heart disease, and unable to recognize an early heart attack.

Most women think they are immune to heart disease, explains Dr. Judith Lichtman, Yale School of Medicine epidemiologist and author of a pilot study examining recognition of heart-attack warning signs in young women. Most women are not thinking of it because they have a 10-year hormonal advantage over men. Even when they are having symptoms, they may call a family member, who is also unaware that their loved one is at risk for a heart attack.

Heart disease is currently the No. 1 killer of women. Although less than 5 percent of these deaths are in young women (32-54 years), 16,000 young women die annually from heart disease. Approximately 40,000 young women are hospitalized due to heart disease. These numbers rival those of breast cancer, explains Lichtman, but the awareness of heart disease and recognition of early heart attacks is far less.

Not only are women not thinking about heart disease, their symptoms are often atypical, confusing both patients and physicians. While men may have the classic central chest pain, women will confuse their chest pain with indigestion or heartburn. Women also experience jaw pain, shoulder pain, sweating, nausea and fatigue.

The study also found that more than half of women experiencing symptoms delayed seeking medical help for more than an hour. Many women seem embarrassed to have symptoms and will not volunteer that information to their physician, says Lichtman. Physicians need to be more aware of heart disease in young women and empower women to present symptoms and feel comfortable recognizing symptoms of an early heart attack.

Given the results of this study, it is important for physicians and young women to be better able to recognize early heart attacks and prevent heart disease. Recognizing early heart attacks helps prevent the larger heart attack, where more heart function is lost, recovery is longer and the risk of mortality is higher. Women who can recognize a possible early heart attack may also be candidates for varying medical and surgical interventions that help prevent the larger, more dangerous heart attack.

— Prevention of heart disease

While recognizing early heart-attack warning signs is important, the best strategy for most young women is preventing heart disease. In a larger study conducted over five years, Lichtman and colleagues hope to more aggressively examine the risk factors that make some young women more prone to heart attacks than others. Currently, young women can still benefit from what we already know about heart-disease prevention.

— Identifying risk factors

There are many risk factors that influence the development of heart disease. The American Heart Association divides these risks into controllable versus uncontrollable risks. I like to divide the risks into risks you were handed at birth and risks that you can change.

For young women, the biggest risk factor for heart disease is a family history of heart disease. In fact, the study found that almost 88 percent of women with heart disease had a relative with heart disease. Race appears to play a role as well. African-American women have higher rates of heart disease than Caucasians.

It is more helpful to focus on risk factors that can be changed. These factors include:

— High blood pressure

— High cholesterol

— Smoking

— Diabetes

— Obesity/overweight

— Inactivity

— Stress

— Diet

Many of these risk factors are interrelated. Obesity and overweight are associated with high blood pressure, high cholesterol and diabetes. Chronic stress can lead to elevated blood pressure or hypertension. A diet high in saturated fat, low in fiber and essential fatty acids frequently leads to high cholesterol.

The best way to assess your or your loved one’s risk for heart disease is to establish a relationship with a physician. Younger women are often overwhelmed with family and career responsibilities and will overlook their own healthcare needs. Regular visits to a physician, typically specializing in family practice, internal medicine or integrative medicine, allow frequent monitoring of blood pressure, weight and cholesterol levels.

Individually, younger women should monitor their diet, exercise and stress level.

Finally, Lichtman offers the following advice for young women trying to prevent heart disease and early heart attacks. Women should:

1. Not think they are immune to heart disease or heart attacks

2. Learn their risk-factor profile and attempt to fix the controllable factors

3. Engage in the healthcare system

4. Understand that a heart attack does not have to be a Hollywood heart attack to be of significant concern

5. Always call someone when they are having symptoms

6. Most importantly, educate the people around them to recognize the signs and symptoms of heart attacks.

The American Heart Association had created a Web site to help women assess their risks for heart disease and learn preventive strategies. Visit www.goredforwomen.org to learn your risk for heart disease. Education and awareness can save your life or the life of someone you love.

(Dr. Bhatia is a physician and fellow at the University of Arizona Program in Integrative Medicine. She has practiced pediatric emergency medicine for seven years and is certified in holistic medicine, nutrition and acupuncture. She is a recurring medical guest on CNN/Headline News. Please feel free to contact her with questions at tasneembhatia8@yahoo.com.)

(The medical information provided in this column is for informational purposes only, and is not a substitute for professional medical advice, diagnosis or treatment. If you have any questions regarding a medical condition, always seek the advice of a medical doctor or other qualified health provider.)

— (e-mail: consumerhealth@upi.com)