ad info
 Diet & Fitness

 Headline News brief
 news quiz
 daily almanac

 video archive
 multimedia showcase
 more services

Subscribe to one of our news e-mail lists.
Enter your address:
Get a free e-mail account

 message boards

CNN Websites
 En Español
 Em Português


Networks image
 more networks

 ad info


  health > heart > story pageAIDSAlternative MedicineCancerDiet & FitnessHeartMenSeniorsWomen

Heart disease top killer of women

The survey of 1,000 women asked what was the greatest health threat they faced.

61% said cancer

7% said heart disease

1% said stroke

May 10, 1999
Web posted at: 11:35 a.m. EDT (1535 GMT)

In this story:

Symptoms - where the genders diverge

Studies of the sexes

Reducing risk of heart disease


From Medical Correspondent Rhonda Rowland

(CNN) -- What is the leading cause of death in women? Most women will say it's breast cancer. So it comes as a surprise to many people that heart disease is the No. 1 cause of death in both women and men.

"One out of two women are going to have, live with, and/or die from heart disease and stroke," said Martha Hill, Ph.D., R.N., a professor at the Johns Hopkins University School of Nursing and immediate past president of the American Heart Association. "It is amazing women are still not getting that message, and one has to ask why."

Hill said women may not know a lot about heart disease because they often see gynecologists, who focus on reproductive health. Also, many doctors are not aware of the risk of heart disease in women because up until 10 years ago, women were largely excluded from heart disease studies.

Symptoms -- where the genders diverge

When men and women suffer a major heart attack, the symptoms are similar.

"It's the sensation of an elephant sitting on the chest, crushing it, a cold sweat and pain running up the left side of the neck and down the left arm," said Hill.

But women tend to report more subjective symptoms such as not feeling good, nausea, dizziness and weakness. These symptoms are often overlooked by both women and their doctors or attributed to something else.

Studies show women also wait longer than men to seek help.

"They were less likely to call 911 and present with an ambulance on arrival; they were more likely to prolong before presenting to the hospital," said Dr. John Canto, University of Alabama at Birmingham.

Because doctors didn't have information and were not looking for heart disease in women, it was often not diagnosed or treated. But recent studies show this may be improving.

Studies of the sexes

Women tend to develop heart disease a decade later than men.

"It's related to the aging process and menopause," said Hill. "The menopausal process takes five to 10 years, during which there's a progressive decline in estrogen, weight increases, blood pressure goes up, and cholesterol levels change."

Studies are looking at the role of estrogen, testosterone and other hormones in the development of heart disease in both sexes.

Other research shows differences in the size and elasticity of coronary arteries in men and women, which could explain differences in heart disease presentation. Studies are also under way to better understand blood vessel activity and differences in exercise, body fat distribution and physical activity.

One study found women with advanced congestive heart failure can live twice as long as men with the condition. Heart failure occurs when the heart muscle is damaged or overworked. It's the only heart failure that is dramatically increasing.

"What we think may be going on is there are biologically differences between men and women that affect the way they respond to the heart failure state," said Dr. Kirkwood Adams, University of North Carolina at Chapel Hill.

Understanding that difference could lead to better treatments.

Other studies show diabetes is associated with an increased risk for heart disease in women, compared to men.

Research studies now under way should yield new information in the next two, five and 10 years.

"Women need to wait, watch, ask about what's new and keep an ear to the ground," said Hill. "They also need to be encouraged to participate in clinical trials so we can get more answers."

-- A statin or cholesterol-lowering drug should be considered instead of hormone replacement therapy as the first line of drug therapy for lowering high levels of cholesterol in postmenopausal women.

-- The target blood level of HDL (or good cholesterol) should be higher than the national average. It is 35 for men and should be 45 for women.

-- Diabetes increases a woman's risk of heart disease three to seven times, compared with a two- to threefold increase in men. Women at risk should be identified and treated.

-- Pregnancy and the preconception period are optimal times to review a woman's risk factor status and health behaviors to reduce future cardiovascular disease.

Source: May 11, 1999 issue of the journal "Circulation"

Reducing risk of heart disease

A Centers for Disease Control and Prevention (CDC) survey showed doctors are missing opportunities to reduce the risk of heart disease. The study of almost 30,000 routine office visits showed women were counseled less often than men about exercise, nutrition and weight reduction.

Uncontrolled blood pressure is the No. 1 cause of stroke and long-term disability and the third leading cause of death.

"Women think of heart disease as an old person's disease and a good way to die," said Hill. "But heart failure is every bit as bad as cancer, and the death rate is higher."

Therefore, women need to take steps to prevent heart disease. That includes knowing your blood pressure and cholesterol levels, exercising and not smoking.

"Women should also talk to their doctors about hormone replacement therapy once they reach menopause," said Hill. "We should have more information in several years about different doses and hormone combinations, so a woman's regimen can be more tailor-made."

Preventing or lowering the chance of heart disease starts at an early age. It's an investment that can pay off in quality years later in life.

An egg a day may not raise heart-disease risk
April 20, 1999
Research links mental stress, more deaths from heart disease
September 3, 1999
Study: Cholesterol drugs prevent heart attacks, yet seldom used
March 8, 1999
Studies find new value in overlooked heart-test results
February 9, 1999
Half of men, third of women will develop coronary heart disease, study finds
January 7, 1999

Johns Hopkins University School of Nursing
American Heart Association
     American Heart Association's Women's Web site
     American Heart Association's A to Z Guide
University of Alabama at Birmingham
University of North Carolina at Chapel Hill
Centers for Disease Control and Prevention
Note: Pages will open in a new browser window
External sites are not endorsed by CNN Interactive.

China SARS numbers pass 5,000
Report: Form of HIV in humans by 1940
Fewer infections for back-sleeping babies
Pneumonia vaccine may help heart, too
Enter keyword(s)   go    help

Back to the top   © 2001 Cable News Network. All Rights Reserved.
Terms under which this service is provided to you.
Read our privacy guidelines.