Cardiovascular disease is the No. 1 killer of women, causing one in three deaths in the U.S. every year, higher than all forms of cancer deaths in women combined.
According to the American Heart Association, women are severely underrepresented in research and clinical trials, with women making up only 38% of participants in clinical cardiovascular trials. The warning signs of a heart condition present differently and more subtly in women than in men, which is why it is so important women understand the risk factors, signs and symptoms unique to them.
To mark American Heart Month this February, Dr. Rachana Kulkarni, a cardiologist with Medicor, an affiliated medical practice of RWJBarnabas Health, and a physician leader with the RWJBarnabas Health Women’s Heart Health Collaborative, outlined how common signs and symptoms for women present, how to reduce the risk of heart disease and the best time to address heart health with your doctor.
Kulkarni said it is important to take care of your heart while you are young to reduce the risk of heart problems later in life, but postmenopausal women should take extra care. After menopause, women lose estrogen, which can help keep plaque from building in the arteries, increasing the chance of cardiovascular problems.
It is a good idea to get your heart checked and talk with your cardiologist about how to keep your heart healthy after menopause. If you have a family history of heart problems or have high cholesterol, high blood pressure, diabetes, smoke, live a sedentary lifestyle or are overweight, it is important to get checked now and to not wait until after menopause.
Women can reduce their risk of heart disease with a healthy lifestyle by following a healthy diet.
“The BMI (Body Mass Index) in America is at an all-time high. Lifestyle plays a key role in heart health, especially for women. I know it can be difficult to fill your plate with healthy fruits and vegetables and ditch salty, fatty fast food, but it is so important to have a colorful plate for a healthy heart,” Kulkarni urges.
In addition to eating healthy Dr. Kulkarni recommends:
- Exercising for at least 30 minutes per day, five times a week;
- Maintaining a healthy weight;
- Avoid smoking and stay away from secondhand smoke;
- Limit alcohol intake;
- Keep up with yearly physicals and appointments with your primary care provider or cardiologist to get necessary screenings and tests; and
- Minimize stress and workload as much as possible.
“Knowing your numbers is one of the most important steps women can take for their heart health,” Kulkarni commented.
She urges women 40 and older to keep track of blood pressure, sugar levels and cholesterol numbers, as well as being well informed of family heart health history because it could very well save your life.
Common signs and recovery process for women pre- and post-heart attack
“For the last three to four decades, women were rarely studied in cardiac clinical trials, and they were just looked at as smaller men. We know this is not the case and we are finding that the signs and symptoms are simply not the same, creating disparities in many of our guidelines,” Kulkarni said.
While some women may experience chest discomfort, which is common in men, they are more likely to present with the following symptoms when heart disease is present:
- Extreme fatigue;
- Nausea or vomiting;
- Shortness of breath;
- Angina;
- Indigestion;
- Pain in the upper neck, shoulders, jaw or teeth.
Because these symptoms are subtle, less well-known and can be attributed to other diseases, women and their families often ignore warning signs until their heart condition becomes serious. Unfortunately, flatlining is the most common presenting symptom of cardiac disease in women, and more women die of out-of-hospital cardiac arrest than men, because they don’t get themselves checked. What’s worse is, women are often not eligible for procedures after they experience a cardiac event such as angioplasties because they waited too long to seek help. Delaying care, being less likely to complete cardiac rehabilitation and ignoring the signs all contribute to negative outcomes that could have possibly been prevented.
Major heart problems that women commonly experience include spontaneous coronary artery dissection, or SCAD, which often occurs in younger women when the blood vessel in the heart tears, and Broken Heart Syndrome or stress cardiomyopathy, which is brought on by a stressful situation. In this case, the heart briefly changes the way it pumps blood and, if the woman receives medical attention in a timely manner, with rehabilitation she can make a full recovery, but this leaves the heart more susceptible to disease in the future. In addition, women are more likely to experience coronary microvascular disease, where chest pain occurs and spasms pinch blood flow. This is much harder to diagnose, and drastically increases a women’s risk for heart attack or other heart diseases.
“While not all factors of heart health can be controlled, taking preventative measures with the factors you can control is an important step to a healthy heart,” Kulkarni added. “It never hurts to get checked and give yourself and your loved ones peace of mind. I urge all women to take charge of their own health and to make it a priority. You cannot take care of everyone else if you are not healthy yourself.”
