Women and Heart Disease

The Facts May Surprise You
Men and women are equally at risk when it comes to heart disease, but until recently, research focused on men. Now that field has been levelled.

It used to be that only men had heart attacks. At least, that used to be the myth. It may have been because men were thought to carry the load when it came to stress; therefore, men were believed to have an increased risk of high blood pressure leading to heart disease. Maybe it was simply because heart disease was seen as a man’s health problem, similar to the way osteoporosis was thought to strike only women.

The truth is women are protected somewhat from heart disease, possibly by natural estrogens. But after menopause, when a woman’s estrogen levels drop drastically, her luck begins to run out. In fact, according to the Heart and Stroke Foundation of Canada, more women die of heart disease than men, and a woman’s risk of heart disease quadruples after menopause. Health Canada reports that two out of every three women have one or more of the major risk factors associated with heart disease, which include menopause, being overweight and having a family history of the disse.

Offering Hope and a Change in Attitude
It’s easy to understand why most of the research into heart disease has centered on men. Women have simply been misrepresented when it comes to research and treatment because they haven’t been seen as a high-risk group. “Previous studies recruited few women,” explains Dr. Eva Lonn, associate professor of medicine and cardiology at McMaster University in Hamilton. That has recently changed. A sub-study of the landmark Heart Outcomes Prevention Evaluation (HOPE) trial found that ramipril, an ACE inhibitor, significantly reduced the risk of stroke, heart attack and death from cardiovascular disease in at-risk patients. The study found the treatment has the same cardio-protective benefits for both men and women. “This is the first study that has enough women to clearly show the benefit of ACE inhibitors in the treatment of women, and the results show the benefits are similar to those attained in men,” says Dr. Lonn, who was a member of the steering committee for the HOPE trial.

The study, published in the Journal of the American College of Cardiology, followed 2,480 women 55 years or older who had established cardiovascular disease or diabetes, as well as other risk factors. Patients were treated daily with 10 milligrams of ramipril or a placebo for an average of 4-1/2 years. For men and women in the study, there was a 22 per cent reduction in the risk of a major event, which is categorized as a heart attack or stroke. “For women alone, there was a 23 per cent reduction in the risk of heart attack, stroke or cardiovascular death,” says Dr. Lonn.

Men and Women: What’s the Difference?
While women may be similar to men in terms of their risk of developing cardiovascular disease, their symptoms can be very different. Most men will experience strong chest pains and pain in the left arm during a heart attack, while some women have what are termed silent heart attacks, so subtle they may not even realize they’ve had a heart attack. However subtle it may feel, the damage to the heart has still been done. Symptoms that women may experience include nausea, back pain, indigestion-like symptoms, anxiety, sweating, and a vague tightening or pain in the chest that can radiate to the neck, jaw and shoulders. As a result, heart attacks in women are frequently thought to be reactions to severe stress, fatigue or indigestion or simply an allergic reaction.

All the more reason why women need to determine their risk factors, address those they can improve and talk to their doctor about the recent study and whether an ACE inhibitor is right for them.

Next page: Are You at Risk?

Are You at Risk?
Preventing heart disease means knowing the risk factors and doing what you can to eliminate them from your life. However, as with every disease, there are risk factors that you can’t control. They include:

Concentrating on those you can control is a proactive strategy to heart health. Risk factors you do control include:

Resources
There is a wealth of information about women and heart disease. To learn more about risks, lifestyle changes that can help or heart disease in general, go online to these Web sites.

This Special Sponsored Feature was produced by the editors of CARPNews 50Plus magazine and concerned health care organizations.