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Q
Why Should Women Worry about Heart Disease?
I was shocked to learn that an acquaintance, a woman age 49, had had a heart attack. How could this happen to a (relatively) young woman? I thought that heart disease affected mostly men.
A
Answer (Published 2/27/2004)

Women often don't realize that heart disease is as much of a threat to them as it is to men. True, the risk for men is higher at a younger age than it is for women, but as women reach menopause, they start to catch up; and by the age of 65, their rate of heart disease equals that of men. In the United States, heart disease remains women's leading cause of death, claiming nearly 500,000 lives per year (compared to about 40,000 for breast cancer, a disease women tend to fear more). Women experiencing heart attacks may not have the classic symptom of crushing chest pain radiating to the left arm. Rather they often have less obvious symptoms such as abdominal pain, fatigue and shortness of breath. This can delay accurate diagnosis and prompt treatment.

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Also, women with heart disease often don't fare as well as men. More women than men die of heart disease each year. After suffering a heart attack, 38 percent of women will die within a year (compared to 25 percent of men); and 35 percent of women (compared to 18 percent of men) who survive a heart attack will have another attack within six years. Women are almost twice as likely as men to die due to complications of coronary artery bypass surgery. Doctors treat them less aggressively; thus women are less likely than men are to receive such drugs as beta-blockers, ACE inhibitors or even aspirin after a heart attack. In addition, rates of such treatments as angioplasties (to open a blocked coronary artery), stents (devices used to hold coronary arteries open) and coronary artery bypass surgery are far lower among women than men; and only 28 percent of implantable defibrillators go to women. In heart-related research studies, women make up only 25 percent of all participants. (Clearly, physicians and researchers need some consciousness-raising about heart disease in women.)

You can lower your risk of heart disease by giving up cigarettes if you smoke, making sure your blood pressure and cholesterol are under control, staying close to your ideal weight for your age (62 percent of American women are overweight), becoming more physically active (about 60 percent of American women don't get the recommended 30 minutes per day of moderate exercise, such as walking) and being checked for diabetes (about 2.7 million women in the U.S. who have this disease are undiagnosed). I also recommend an anti-inflammatory diet with lots of omega-3 fatty acids, either in the form of omega-3 rich foods or as supplements.

Andrew Weil, M.D.

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