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New heart-health guidelines issued for women

Often overlooked: Heart disease No. 1 killer of women

Often overlooked: Heart disease No. 1 killer of women

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CNN's Holly Firfer shares new heart-health guidelines specifically for women.
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(CNN) -- Heart disease is the leading killer of both genders in the United States, but until now, women had to rely on prevention and treatment guidelines based on research on men.

On Wednesday, the American Heart Association outlined measures for women to combat and prevent cardiovascular disease, the first evidence-based guidelines for women.

"For the first time we are giving clarity about how much we know and how much we don't know," said Dr. Lori Mosca, who helped write the guidelines and is director of preventive cardiology at New York-Presbyterian Hospital/Columbia University Medical Center.

"The concept of cardiovascular disease as a 'have-or-have-not' condition has been replaced with the idea that [it] develops over time and every woman is somewhere on the continuum."

The new prevention guidelines aimed at women urge at least 30 minutes of moderate physical activity most days; quitting smoking; and that high-risk women receive cholesterol-lowering drugs, preferably statins, and take omega 3 and folic acid supplements.

Also included are some guidelines of what not to do. The AHA says doctors should not recommend hormone replacement therapy, once thought to increase heart health. In recent years, however, HRT has come under fire for increasing the risk for a number of diseases.

The routine use of aspirin in lower-risk women was also discouraged but encouraged in high-risk women. Women with a 10 percent or less risk of having a heart attack in the next 10 years are considered low risk; those with a 10 percent to 20 percent chance are intermediate-risk, and those with a 20 percent or higher chance are high-risk.

"Overwhelming evidence suggests that [cardiovascular disease] can be prevented in both women and men," Mosca said. "These recommendations should help health-care providers and the public avoid initial or recurrent heart attacks and strokes."

AHA figures show that about half a million women die of heart disease and strokes each year, killing more than the next seven causes of death combined, including cancer.

In comparisons between the genders, WomenHeart, the National Coalition for Women with Heart Disease, says that 38 percent of women and 25 percent of men die within one year of a heart attack; women are twice as likely as men to die after a bypass; and 35 percent of female and 18 percent of male heart attack survivors will have another heart attack within six years. Despite these and other statistics, women comprise only 25 percent of participants in heart research studies, the group says.

Helping kick off American Heart Month, first lady Laura Bush began campaigning this week to raise awareness about heart disease among women.

"Women just don't expect to have a heart attack. They think heart attacks are for men," she told CNN Monday. "So women seek help a lot later than men do. ... And because of that, they suffer more damage because they get to the hospital later when they are having a heart attack than most men do."

According to the National Coalition for Women with Heart Disease, more women than men die of heart disease each year, yet women receive only 36 percent of open-heart surgeries and 33 percent of angioplasties.

Heart disease can show itself differently in men and women. Symptoms in women traditionally include feelings of indigestion or backache, dizziness, fatigue and numbness, said Dr. Nieca Goldberg, with the Lenox Hill Hospital in New York. So-called "classic" symptoms -- which occur more often in men but can crop up in women -- are pressure and squeezing pain in the center of the chest, lightheadedness, fainting and shortness of breath.

The AHA says new research shows that women are beginning to realize the importance of good heart health. The group's first survey in 1997 found that only 30 percent of women knew that heart disease was their leading cause of death. But today, about 46 percent of women realize the danger, according to the information released Wednesday.

Risk factors for cardiovascular disease in both men and women include high cholesterol and blood pressure, smoking, not exercising, obesity, stress and a family history of heart disease and stroke.

The guidelines are published in the AHA's Circulation journal.


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