Women and Heart Disease: How to Reduce Risk

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The demands of holding a job, running a household and very often doing both can leave many women feeling fatigued. While fatigue can be normal, it can also be a symptom of heart disease in women, according to experts.

"Many women typically do not exhibit what we have come to regard as the classic symptoms of coronary artery disease," said Dr. Alan K. Tannenbaum, a cardiologist at Robert Wood Johnson University Hospital in New Brunswick. "We usually associate having a heart attack with a crushing pain in the chest. In fact, many women will have only fatigue, shortness of breath or just a vague sense of not feeling
well."

About 227,000 women will die from heart disease this year, roughly the same as the number of men, yet women - and sometimes their doctors - often face a greater challenge recognizing cardiovascular disease, according to Dr. Tannenbaum.

"Heart disease isn't just a man's disease," he said. "Women are just as much at risk, but there are steps they can take to keep their hearts healthy."

Understanding risk factors is the key, he said. A woman with a strong family history of heart disease should speak to her doctor about the advisability of having a stress test as part of disease surveillance. This is especially true of women who have already experienced menopause, when the loss of natural estrogen appears to leave the body more vulnerable to cardiovascular disease.

While a woman can't control a risk factor such as family history - or age - there are some risk factors that can be controlled, such as high cholesterol, high blood pressure and unhealthy habits, most notably smoking.

"Women who quit smoking, lower their cholesterol and learn to handle life's daily stress will reduce their chances of heart disease regardless of their family history," said Dr. Tannenbaum, who is also the director of the hospital's Cardiac, Exercise and Rehabilitation Training Program. "These are the risk factors to concentrate on."

A healthy diet and exercise play an important role in keeping cholesterol and blood pressure at normal levels. Thirty minutes of physical activity most days of the week is recommended. For those with high cholesterol, a low cholesterol-low saturated fat diet helps to reduce the cholesterol level. Cholesterol medication is also sometimes necessary to supplement diet and exercise.

To decrease the risk of high blood pressure, it's important for women to maintain a healthy weight, meaning they are no more than 20 pounds heavier than the recommended weight for their height. Family history, age, oral contraceptives and pregnancy increase a woman's risk of developing high blood pressure. She should consult her doctor if any of these factors exist.

Diabetes also increases a woman’s chance of developing heart disease. Family history, poor diet and lack of exercise increase the risk of diabetes. It's important for those with diabetes to maintain control of the condition and women with a family history should be tested.

"Even women who are in good health need to eat a balanced diet and exercise regularly," noted Dr. Tannenbaum. "Doing so will not only reduce the risk of heart disease but the risk of other health problems as well."

Robert Wood Johnson University Hospital, one of the nation’s leading academic health centers, is the principal hospital for UMDNJ-Robert Wood Johnson Medical School and a member of the Robert Wood Johnson Health System & Network. For more information, please call the hospital's main phone number at 732-828-3000, the RWJUH Physician Referral Line at 888-795-8411 or visit www.rwjuh.edu.

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