The truth is, more than 450,000 American women die from heart disease each year. For two decades, it has killed more women than men, and the gap is actually widening as mens heart attack death rates improve faster than womens. Yet only a third of women in the United States consider themselves at risk for heart disease, according to a 2006 poll.<\/p>\n “Most women worry far more about breast cancer<\/a> than heart disease,” says Elsa-Grace V. Giardina, MD, cardiologist and director of the Center for Womens Health at New York Presbyterian Hospital and Health Editorial Advisory Board member. “But for every woman who dies from breast cancer, 10 die from heart attacks.”<\/p>\n There have been advances: Heart disease deaths in women actually declined between 2003 and 2004. But the lifetime risk of dying of cardiovascular disease (CVD) is still nearly one in three for women. And thats why the American Heart Association (AHA) recently released new guidelines underscoring the importance of healthy lifestyles in women of all ages to reduce the long-term risks of heart and blood vessel diseases.<\/p>\n Next Page: Forget most of what you already know about heart attacks<\/a> [ pagebreak ]For starters, you need to forget most of what you already know about heart attacks. The conventional wisdom has long been based on the male experience, but doctors are now realizing that heart disease can be very different for women—from symptoms to diagnostic tests to effective treatments.<\/p>\n Even when doctors suspect heart disease and order an angiography or angiogram<\/a> (a diagnostic X-ray of the heart and its blood vessels), they often dont see problems, something that has long baffled them. But findings of a 10-year study by the National Institutes of Health—the Womens Ischemia Syndrome Evaluation (WISE) completed in 2006—appear to unravel the mystery.<\/p>\n WISE researchers discovered that two-thirds of the study participants with chest pain had “clear” angiograms, but half of those women had a condition called coronary microvascular sydrome, in which plaque coats small arteries in the heart rather than building to clumps in larger vessels.<\/p>\n “Instead of discrete obstructions, the plaque is evenly distributed throughout the blood vessels, so its pretty much invisible on the angiogram,” says Dr. Goldberg, who's also an AHA spokeswoman.<\/p>\n Next Page: Vessels become more narrow and rigid<\/a> [ pagebreak ]Nonetheless, the vessels become more narrow and rigid, and less permeable. This, in turn, chokes off the flow of blood and oxygen to the heart muscle (a condition called ischemia), leading to chest pain and potentially a heart attack. Researchers estimate that as many as three million women have the syndrome, sometimes referred to as small-vessel heart disease.<\/p>\n The medical tests used in the WISE study to identify the syndrome are not yet widely available, but one common procedure can spot it: a nuclear stress test, in which thallium is injected into the bloodstream. Using a special camera, physicians then observe how well the radioactive material moves through the blood vessels supplying the heart.<\/p>\n “For years cardiologists thought that stress tests didnt work well for women because, after they turned up problems, the angiogram would come up clear,” Dr. Goldberg explains. “Now we know that the angiogram can sometimes be inaccurate for women.”<\/p>\n Thats why, no matter what the angiogram shows, a poor result on the nuclear stress test calls for treatment. But standard procedures, such as angioplasty and bypass surgery<\/a>, arent always the answer. Angioplasty uses an inflatable balloon to open clogged arteries and a mesh tube called a stent to keep them open. And bypass surgery involves grafting blood vessels from other parts of the body, such as the arms and legs, onto the heart to bypass clogs.<\/p>\n With small-vessel heart disease, there are no discrete clogs to clear or bypass; the problem lies in smaller blood vessels coated with plaque. A better solution—and, happily, a much less invasive one—is drug therapy to reduce blood cholesterol (and therefore plaque), to thin the blood (improving flow), and, in some cases, to limit the pace of the heart (easing its burden). Reducing other heart disease risk factors, such as poor diet and lack of exercise, is also effective.<\/p>\n![\"Heart_WhyDying225.jpg\"](\"https:\/\/imagesvc.meredithcorp.io\/v3\/mm\/image?url=https%3A%2F%2Fstatic.onecms.io%2Fwp-content%2Fuploads%2Fsites%2F12%2F2001%2F09%2FHeart_WhyDying225.jpg\")
Heart_WhyDying225.jpg<\/span> and left arm numbness. But thats not always the case for women,” explains cardiologist Nieca Goldberg, MD, associate professor of medicine at the New York University School of Medicine and director of the NYU Womens Heart Program. “Women commonly experience different symptoms, such as shortness of breath<\/a>, fatigue, pressure in the abdomen, and jaw pain.” And these are often misidentified as stomach ailments or anxiety attacks, so the early warning signs go unheeded.<\/p>\n
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