WOMEN AND HEART DISEASE

Is heart disease mainly a problem for men? According to the American Heart Association, the answer is a resounding NO.  in fact, data indicate that 53% of all cardiovascular disease deaths occur in women.  Cardiovascular disease is the leading cause of death for American women and kills nearly twice as many women as do all forms of cancer combined.  Presently, one in five women has some sort of heart or blood vessel disease.  Over 60% of stroke deaths occur in women.  Also 38% of women who have heart attacks will die within a year, compared with 25% of men.  From age 55, higher percentages of women than men have high blood pressure.

For many years, it was thought that men were at much risk than women for the development of cardiovascular problems.  Today it is known that young men are more prone to heart disease than young women, but once women reach menopause (usually in their early to middle 50s), their rates of heart-related problems quickly equal those of men.

The protective mechanism for young women seems to be the female hormone estrogen.  Estrogen appears to help women maintain a beneficial profile of blood fats.  When the production of estrogen is severely reduced at menopause, this protective factor no longer exists.  Prescribing estrogen replacement therapy (ERT) was a common practice by many physicians in treating a number of factors in postmenopausal women.  One of the benefits of ERT was considered to be prevention of  cardiovascular diseases.  However, in 2002 a major clinical research trial was stopped due to the finding that more women on ERT were experiencing heart attacks and strokes.  Thus, the American Heart Association now recommends that ERT should not be used for the purpose of preventing cardiovascular diseases.  Certainly, ERT may still be utilized for other purposes (i.e., relief of menopausal symptoms or osteoporosis prevention).  Women who are prescribed ERT need to be aware of the increased risk for cardiovascular disease in evaluating its value.  Certainly, much more research is underway that may influence the use of ERT in the future.  Women should discuss the risks and benefits of ERT with their physicians.

Young women should not rely solely on naturally produced estrogen to prevent heart disease.  The general recommendations for maintaining heart health – good diet, adequate physical activity, monitoring blood pressure and cholesterol levels, controlling weight, avoiding smoking, and managing stress – will benefit women at every stage of life.