One of the hottest areas of medicine in both cutting edge research laboratories and on the wards of the nations most prestigious hospitals may surprise you. It is neither an exotic infectious disease nor any type of unusual genetic abnormality – it is in fact the #1 killer of women in the United States – Heart Disease.
For years, almost all the information doctors and health professionals had about the natural course of heart disease was studied in groups of men. It turns out the way women develop blockages in their arteries is completely different than in men and in fact, many of the classic ways men come to the hospital complaining of chest pain radiating to the jaw or arm does not apply to women. Researchers now know that heart disease and heart attacks has been completely underestimated and missed in women due to these differences. In addition many ethnic minorities and elderly women have been excluded from much of the research conducted, adding to the limited knowledge of how heart disease presents in women. Over the past few years a growing recognition of the unique presentation of the disease in women has led to an explosion in research and awareness into cardiovascular disease in women.
Scientists are beginning to recognize that heart disease in women often lags approximately 10 years behind that of men. More serious complications such as heart attacks and sudden death often show up 20 years after they typically do in men. In addition a woman at age 65 is more than twice likely to die from a heart attack than her male counterpart. Women are also more likely to die from open heart surgery than men.
Less than 50% of women recognize that heart disease is their leading killer - over half a million people are killed each year. This has led recently to leading medical societies offering specific recommendations for the care of women’s heart disease.
Women should see their doctor to have their risk for developing heart disease determined. Specific scoring systems for women have been developed which take into account various factors including diabetes and vascular disease. Based on these scoring systems a women’s doctor can recommend specific lifestyle modifications including “heart-healthy” diets and exercise programs. Newer therapies such as omega-3 fatty acids and folic acid, as well as, the recognition and treatment of other conditions such as depression may have additional benefit in combating heart disease in women.
Without a doubt, the most important steps that need to be taken in this emerging area of Cardiology are the increased awareness of this growing problem. New research in the relationship between female hormones and their specific effects on the development of heart disease is ongoing. More clinical trials are enrolling women of all ages and races to broaden our perspective on the unique aspects of heart disease in women. Most important, providing women with the knowledge and information about the seriousness of heart disease will go a long in way in bringing problems to their doctor’s attention early and slowing down America’s #1 killer.