FORT LEE, Va. (Feb. 24, 2011) -Fifty-two-year-old Karen (not her real name) will always remember that time in November 2008 when she went to the emergency department and for three hours was evaluated for abdominal pain and nausea. All of the standard tests for abdominal pain were ordered, and they all came back negative. She was treated with antacids and narcotics, but it did not relieve her discomfort. Finally, the doctors decided to obtain an EKG and cardiac enzymes (a blood test to determine a heart attack), and much to everyone's surprise, she WAS having a heart attack.

Are women at risk?

Women are at risk for heart disease, strokes and heart attacks just like men. In fact, heart attack, stroke and other forms of cardiovascular diseases are devastating to women. Many people believe that cancer is more of a threat, but heart disease is the leading cause of death in American women. According to the American Heart Association, nearly twice as many women in the United States die from heart disease, stroke and heart attacks as from all forms of cancer including breast cancer.

Women develop heart disease later in life than men - typically seven or eight years later. However, by the age of 65, a woman's risk of developing heart disease is almost the same as a man's. Also, the rates of heart attacks over the last 20 years have been increasing for women 35-54 years of age. It's time women started paying attention to their heart health.

What are the symptoms of a heart attack in women?

Like men, the most common sign of a heart attack for women is chest pain or discomfort. However, women can have a heart attack without any feelings of chest pain such as shortness of breath, pain or numbness in the jaw, neck, arms or back, nausea, vomiting, indigestion, sweating, sudden or overwhelming fatigue or dizziness.

What are the risk factors for heart disease?

The American Heart Association has identified several factors that may increase the risk of a heart attack or stroke. You can't control some of these risk factors, but you can modify or control most of them.

The risk factors that you can't control are these:

Age - as we grow older the risk for heart disease increases.

Gender - men have a greater risk of heart attack than women, but about 55,000 more women than men have strokes. About 60 percent of stroke deaths occur in women. There are more women who die from a first heart attack than men.

Family History - if a close blood relative (parent, sister, brother) has had heart disease, this increases the risk in both men and women. Race is also a factor; African-American women have a greater risk of heart disease and stroke and are more likely to die from this disease than Caucasian women.

Previous Heart Attack, Stroke or Transient Ischemic Attack - Twenty-two percent of women age 40-69 who survive a first heart attack or stroke will have another heart attack or fatal coronary artery disease event (stroke or TIA) within five years.

The risk factors that you can control or modify are:

Smoking - according to the American Heart Association, smoking is the single most preventable cause of death in the United States. More than half of the heart attacks and strokes in women are related to smoking.

Women who smoke and use birth control increase the risk even more. Enrolling in a smoking cessation class is a great way to stop smoking.

High Blood Pressure

High Cholesterol

Weight

Physical Activity

Diabetes

Will Medications Lower Your Risk for Heart Disease?

Cholesterol lowering medications (statins) lower the risk of heart attacks in men. However, there is not enough evidence to show that these medications work as well in women who have never had a heart attack. If you have already had a heart attack, statins may decrease your risk of having another heart attack.

Taking an aspirin a day may lower the risk of stroke or second heart attack in women. The risks may outweigh the benefits. Particularly for smokers and diabetics, it is important to take aspirin because smoking and diabetes makes platelets sticky, causing them to clump together and make it easier to stick to the artery walls. Talk to your health care provider first before taking aspirin.

Estrogen therapy was prescribed by doctors because they hoped it would help guard against certain diseases and help relieve the symptoms of menopause. It was once thought the estrogen therapy could help prevent heart disease. New studies show that estrogen may not help in the prevention of heart disease. Talk to your health care provider if you are currently on or are considering taking this therapy.

One reason many women aren’t concerned about heart disease is that they think it can be "cured" with medications or surgery. This isn’t the case. Once you have heart disease, you will always have heart disease. True, procedures such as by-pass surgery and angioplasty can help blood and oxygen flow easier. But the arteries remain damaged which means you are more likely to have a heart attack unless you make changes in your daily habits.

Talk to your health care provider about your heart health before it is too late.

Ms. Benton is a Family Nurse Practitioner working in the Primary Care Clinic at Kenner Army Health Clinic. She worked as a Cardiology Nurse Practitioner prior to coming to work at Kenner Army Health Clinic.

– if you have diabetes, you are two to four times more likely to die from heart disease than people without diabetes.– remember, your heart is a muscle. It needs exercise just like any other muscle to work effectively. If you are inactive and eat too much, you tend to gain weight which can cause high blood pressure, high cholesterol, diabetes, heart disease and stroke. According to the American Heart Association, you should exercise 45 minutes on most days. Pick an activity that you enjoy such as biking, walking or dancing and do it. Get a buddy to exercise with. Don’t let the cold weather stop you. You can wear an extra layer of clothes. – extra weight puts extra stress on your heart. Being overweight puts you at risk for health problems such as diabetes, high cholesterol and heart disease. A waist measuring 35 inches or more for women and 40 inches or more for men is a risk factor. A diet rich in fruits and vegetables, lean meats and whole grains, such as the Mediterranean diet, will help shave off those extra pounds. Don’t think of it as a diet, think of it as a lifestyle habit; something you do regularly. – high cholesterol is a major risk factor for heart attack and stroke. High levels of LDL (low density lipoprotein) cholesterol (the "bad cholesterol") raise the risk of heart attack and stroke. High levels of HDL (high density lipoprotein) cholesterol (the "good cholesterol") lower the risk of heart disease. HDL removes cholesterol from the bloodstream and carries it to the liver to be broken down and excreted. Low levels of HDL are a greater risk factor for women than for men.– this is a major risk factor for heart attack and the most important risk factor for stroke. Women have an increased risk of having high blood pressure if they are overweight, have a family history of high blood pressure, are physically inactive, take certain types of birth control, consume a diet high in fat and salt or have reached menopause. A healthy diet, exercising and losing weight can help control blood pressure.