For a long time, coronary artery diseases were thought of as a health problem that mostly affects men. However we now know it's not just a man's problem. Recent studies showed that CAD is known to be the leading cause of death for women in the United States and Canada, responsible for about 1 in 4 female deaths each year. Unfortunately, only 1 in 3 women identify cardiovascular disease as the greatest health problem facing women today. A survey data suggest that on a day-to-day basis, women still worry more about getting breast cancer than heart disease even though heart disease kills six times as many women every year. There are many reasons to think that CAD is different in women. A woman's symptoms are often different from a man's, making the diagnosis of acute coronary syndromes (ACS) often more challenging, especially in young women. So it is important to recognize differences in the signs and symptoms at presentation, in order to improve patient management and outcomes. As it is in men, many risk factors can contribute to the event of CAD, However some risk factors may affect women's to a greater extent:
Hyperlipidemia: Before menopause, a woman's own estrogen helps protect her from heart disease by increasing HDL (good) cholesterol and decreasing LDL (bad) cholesterol. After menopause, women have higher concentrations of total cholesterol than men do, increasing the risk of death from heart disease in women over age 65.
Diabetes: Diabetes increases the risk of heart disease in women more than it does in men, perhaps because women with diabetes more often have added risk factors, such as obesity, hypertension, and high cholesterol, or because they are often older when diagnosed with CAD.
Smoking: Studies showed that it is a greater risk factor for heart disease in women than it is in men. Symptoms of cardiovascular disease tend to occur about 10 years later in women than it is in men, and many women don't experience the crushing chest pain that is a classic symptom of a heart attack in men. Some feel extremely tired or short of breath, other atypical symptoms include nausea, abdominal, neck, or shoulder pain, and unusual rapid heartbeat. During a heart attack, only about one in eight women report chest pain; even then, they described it as pressure, aching, or tightness rather than sharp pain. Because women don't always recognize their symptoms as those of a heart attack, they tend to show up in emergency rooms after heart damage has occurred. Diagnostic tests, including blood tests, an electrocardiogram (ECG), echocardiogram, exercise stress test, coronary computed tomography angiogram (CTA), or cardiac catheterization can help provide a more complete and accurate picture of a woman’s heart health. Women have smaller and lighter coronary arteries than men do. This makes treatment options such as angiography, angioplasty, and coronary bypass surgery more difficult to do, thereby reducing a woman's chance of receiving a proper diagnosis and having a good outcome. Women tend to have more complications following surgery, and they are twice as likely to continue having symptoms several years after coronary angioplasty, as they are usually older than men and have more chronic conditions at the time of their first coronary event. Cardiac rehabilitation can improve health and aid recovery from heart disease, however, women are less likely to be referred for cardiac rehabilitation. Heart disease is much more common in women than many people realize, while it may not be possible to completely eliminate risks for heart disease, women can take further steps to reduce it. These include:
Quit smoke, actively or passively.
Make changes in diet that may help controlling blood cholesterol, blood pressure and blood sugar if diagnosed with any.
Increase the level of exercise/activity to help achieve and maintain a healthy weight. Moderate exercise for 30 minutes a day, on most days is recommended, but check with your doctor before starting an exercise program.
Reduce stress and treat depression.
If a woman had a heart attack before, doctors might recommend starting a low-dose aspirin every day in order to help prevent another attack, but never start taking aspirin for heart disease prevention without medical consultation.