Take Good Care of Your Achy Breaky Heart

One in Three Women Die of Heart Disease in the US Every Year

While still the number one cause of death in the U.S., according to the Centers for Disease Control, awareness has been dropping steadily over the past 10 years.  Although it’s commonly thought of as a “man’s disease,” almost one American woman per minute is dying of heart disease; yet many women are still dangerously unaware of the risk factors.

Heart disease refers to a range of conditions, but the most common is coronary artery disease, which affects the blood flow to the heart. In addition to heart attacks, there are also heart rhythm problems like arrhythmias, heart defects you’re born with (also known as congenital heart defects), heart valve disease, etc.  Almost half of all Americans have at least 1 of the big 3 key risk factors for heart disease: high blood pressure, high cholesterol, and smoking, according to the CDC. However, some of these risks can’t be controlled because of factors such as your age and family history.

Katie Couric’s Morning Brew (KCM) spoke to two cardiologists committed to encouraging women to be proactive about their heart health: Lisa Freed, director of the Women’s Heart and Vascular Program at Yale New Haven Hospital, and Jennifer Haythe, co-director of the Columbia Women’s Heart Center.  “Women need to know that their longevity is crucial for their families,” Dr. Haythe says, “and to teach their own daughters that it’s important to take care of yourself and not just everyone else.”  “We must remember that heart disease isn’t just having a heart attack,” Dr. Haythe told us, “There are so many different forms of heart disease.”  Dr. Freed reminded us that “women, in particular, now have more they need to worry about.”

Lisa Freed, MD, FACC

In May 2020, the American College of Cardiology updated its guidelines for preventing cardiovascular disease in women. While traditional risk factors like hypertension and diabetes still apply, there are a number of others that have been added that are unique to women. For instance, pregnancy-associated conditions, such as gestational diabetes and preeclampsia increase the future risk of heart disease. This is also true for women who suffer from miscarriages and stillbirths, who are two times more likely to develop heart disease. “Even if you get through your pregnancy and your diabetes gets better once you deliver, it’s still an extra risk later on in life,” Dr. Freed explained. Other newly identified risk factors include menopause, premature menopause, and Polycystic Ovarian Syndrome (or PCOS). “We’ve been saying this to women for a while, but now the guidelines actually support it,” she said.

What are the Symptoms?

Symptoms can vary depending on the kind of heart disease you have and whether you’re a man or a woman. For instance, with a heart attack, men are more likely to have chest pain, while women tend to have additional symptoms along with chest discomfort, such as shortness of breath, nausea, and extreme fatigue.

But Dr. Freed told us that chest pains remain the biggest red flag for everyone. “It is absolutely true that women have more atypical symptoms than men,” Freed said. “But — and this is the big but — chest pain is still the number one symptom for men and women.”  Sometimes heart disease may even be “silent.”   That’s why Dr. Haythe emphasizes that “if you think something might be wrong, take it seriously because when it comes to the heart, time is muscle.”

What Steps Can Women Take to Decrease Their Risk or Prevent Heart Disease?

Jennifer Haden Haythe, MD

The good news is that most forms of heart disease are very treatable today. There’s some evidence that being proactive about keeping your blood pressure and cholesterol low can at least partially reverse plaques in the coronary arteries. “Common sense is very much at play when it comes to heart disease and that’s not true of other diseases like certain cancers,” Dr. Haythe told us. But prevention is key: A growing number of studies suggest many Covid-19 survivors experience some type of heart damage, even if they didn’t have an underlying heart condition.

Then there’s making sure you visit your primary care doctor at least once a year for a regular check-up, even if you don’t think anything’s amiss. And if you haven’t already, start incorporating healthy eating and some regular exercise. But how much is enough? The American Heart Association recommends adults get at least 150 minutes per week of moderate-intensity aerobic activity like a brisk walk or 75 minutes per week of vigorous aerobic activity like running or cycling. You should also avoid smoking at all costs because Dr. Freed says it’s “definitely more potent for women.”

Lastly, don’t neglect your mental health. Depression, anxiety, and acute or chronic emotional stress are typically more prevalent among women than men. Dr. Haythe says the key is learning to unplug — literally. She recommends putting down your phone especially before bedtime and trying some yoga or stretching instead of scrolling through social media. Listen to your heart

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