Heart Disease And Women

Heart disease affects men and women in different ways—and alternative treatments are available for women that may help reduce cholesterol and increase heart health.

Warning Signs

One of the first symptoms of coronary heart disease for women is chest pain, also known as “angina”. The chest pain occurs behind the breastbone and may travel down the left arm or up the neck, or is a squeezing, pressing sensation that does not change with breathing. It is usually caused—and made worse—by exertion and eased by rest. The pain usually lasts 2–5 minutes. If your loved one experiences this kind of pain, contact her doctor.

Reduced blood flow to the heart can cause symptoms other than chest pain. For example, some women get a less typical angina; the chest pain may linger or occur in a different location than behind the breastbone. Some women have shortness of breath or symptoms of indigestion. If your loved one has such symptoms, she should talk with her doctor. Without treatment, the symptoms may recur, worsen, and lead to a heart attack.

Factors Putting Women’s Hearts At Risk

One in 10 American women ages 45–64 has some form of heart disease, and the numbers go up dramatically with age. Some factors that increase the risk for heart disease cannot be controlled—but most can.

Uncontrollable Risk Factors

  • Older than age 55
  • A family history of heart disease

Controllable Risk Factors

  • Cigarette smoking
  • High blood pressure
  • High blood cholesterol
  • Overweight
  • Physical inactivity
  • Diabetes

Risk factors multiply with additional effects. For example, if a woman smokes and has high blood pressure and high cholesterol, she is eight times more likely to develop coronary heart disease than a woman with no risk factors.

Some Tips To Lower Blood Cholesterol

Many women with coronary heart disease can lower their high blood cholesterol through lifestyle changes, although cholesterol-lowering drugs and hormone replacement therapy may be needed, as well.

Lifestyle changes require adopting a healthy eating plan, becoming physically active, and losing excess weight. For a healthy diet, your loved one should consider an intake of:

  • 30 percent or less of her day’s total calories from fat
  • Less than 7 percent of her day’s total calories from saturated fat
  • Less than 200 milligrams of dietary cholesterol a day
  • Only enough calories a day to achieve and/or maintain a healthy weight

Hormone Replacement Therapy

During menopause, the ovaries essentially stop all production of the hormone estrogen. Menopause can occur naturally or surgically.

Hormone replacement therapy (HRT) supplies the estrogen that the body no longer produces. It has been used to relieve the symptoms of menopause, such as hot flashes and flushes, sweats, disturbed sleep, and increased rate of bone loss.

New information from the Postmenopausal Estrogen/Progestin Intervention Trial (PEPI) suggests that HRT may also improve coronary heart disease risk factors after menopause. The research found that estrogen given alone, or with natural or synthetic progesterone, increased HDL (good cholesterol) and decreased LDL (bad cholesterol).

Progesterone is also a hormone made by pre-menopausal ovaries to help control the growth of cells that line the uterus. None of the HRT therapies tested affected blood pressure or weight, but estrogen taken alone caused abnormal cell growth of the lining of the uterus.

PEPI’s findings offer these guidelines:

  • If your loved one has her uterus, she may want to consider a combination therapy that uses both estrogen and progesterone. If she has a uterus and takes estrogen alone, she needs to have a yearly endometrial biopsy.
  • If your loved one doesn’t have her uterus, she may consider taking estrogen without progesterone.

However, uncertainties remain concerning this type of therapy, including the effects of HRT on breast cancer. Current evidence suggests that there is a small increased risk of breast cancer from HRT, but for most women the benefits of HRT probably outweigh the risks. If your loved one is attempting to manage her heart disease by lowering her blood cholesterol, she should discuss the positives and negatives of hormone replacement therapy with her doctor.

© Copyright FamilyCare America, Inc. All Rights Reserved.

Adapted from Facts About Heart Disease and Women: So You Have Heart Disease? NIH Publication No. 95-2645, developed by the United States National Institutes of Health National Heart, Lung, and Blood Institute.



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