Heart Valve Institute

Heart Health Blog

Women and Coronary Arterial Disease

Bradford Blakeman, MD, FACS
Medical Director, Heart Valve Institute, St. Mary Medical Center

These facts may surprise you.  Coronary Arterial Disease (CAD) is the number one killer of women over the age of 25.  In fact, it kills twice as many women as all types of cancer - including breast cancer.  CAD is also the leading cause of disability in women.  More women die of heart disease than men each year and two-thirds of women fail to make a full recovery from a heart attack.  Many women have large heart attacks before they come to the attention of their physician.

Symptoms of heart disease in women differ greatly from men.  The most common symptom is still chest pain, but women also frequently have a variation of pain involving the neck, shoulder, or abdomen.  Women more likely have shortness of breath, nausea, sweating, dizziness or unusual fatigue.

The risk factors for women are similar to those of men.  The greatest period of risk occurs after menopause when women have lost the protective effect of estrogen.  Genetic history of CAD is still the most dangerous predictor and if a woman has a family genetic history, medical attention should be obtained before menopause.  Other risk factors include metabolic syndrome (fat in abdomen, hypertension, high glucose, and elevated triglycerides) smoking, mental stress or depression, and obviously low estrogen levels particularly after menopause.

There are several ways of lowering the risk of CAD.  These include exercising for 30 to 60 minutes daily, quitting smoking, maintaining a low saturated fat and low cholesterol diet, managing blood pressure, and if needed, an evaluation  for depression.

In conclusion, women of all ages with a strong family history of CAD should seek cholesterol checks and the advice of their health care provider.  Estrogen supplement and the timing after menopause should also be discussed with your doctor.  Check with your physician before starting an exercise regimen.  And once an exercise program is started, be sure to vary the types of activity to keep your interest level high.   Your physician can provide advice on means to quit smoking, blood pressure management, and treatment of depression.  Be aware of your genetic background and seek medical attention early. 

Prevention is still the best treatment for CAD.