Young women overlook heart risks

Research suggests many American women don't understand their risk for heart disease.

Although long thought of as a man's disease, heart disease afflicts as many women, though women tend to develop and die from it about 10 years later than men. And while coronary mortality rates have declined overall, there are signs that the disease, its precursors and its potentially fatal consequences are increasing among young women.

A 2007 study referred to the rise in cardiovascular risk factors among young women as "the leading edge of a brewing storm."

While so many women worry about cancer, only slightly more than half realize that heart disease is their No. 1 killer, according to the Centers for Disease Control and Prevention. More women in the United States die from cardiovascular causes -- heart disease and stroke -- than from all forms of cancer combined.

Campaigns by the American Heart Association and other organizations have aimed to raise awareness among women of self-inflicted risks and of symptoms that are typically far more subtle in women than in men.

"Even if they believe they're having a heart attack, 36 percent don't call 911," said Dr. Holly S. Andersen, director of education and outreach at the Perelman Heart Institute at Weill Cornell Medical College, citing the latest heart association national survey.

Rather than crushing chest pain, women in the throes of a heart attack more often experience discomfort in the neck, jaw, shoulder, upper back or abdomen, dizziness, nausea, right arm pain, shortness of breath, and sweating or unusual fatigue. Almost two-thirds of women who die suddenly of a heart attack had no earlier symptoms.

Doctors too often fail to take a woman's risk seriously and treat it aggressively, or to provide adequate recommendations for prevention, Andersen says. "This is especially true for young women," she said.

DOING DAMAGE

There are ample reasons. Stress, for example, is a known, though not often cited, risk factor, "and the youngest women in this country are more stressed than ever," Andersen said. "They're always 'on' and self-comparing."

Smoking -- marijuana as well as cigarettes -- is a coronary risk.

Two other risk factors, obesity and diabetes, have become more prevalent, especially among Hispanic women born in the United States, half of whom develop diabetes by age 70.

"We're good at treating heart disease, but we're failing at prevention," Andersen said.

FALSE SECURITY

When women with high levels of artery-damaging LDL cholesterol are prescribed statins, the treatment often provides "false reassurance" that the drugs "can compensate for poor dietary choices and a sedentary life," Dr. Rita F. Redberg, a cardiologist and the editor of JAMA Internal Medicine, wrote last year.

A diet rich in fruits and vegetables, which contain natural antioxidants that statins don't provide, is important, Andersen said. "So is getting regular aerobic exercise, spending time with friends and getting a good night's sleep -- six to eight hours," she said. "Chronic lack of sleep doubles the risk of heart disease."

Coronary risk is also greater among women who carry extra weight around the abdomen -- the so-called apple shape. Abdominal fat is metabolically active and can result in high blood pressure and diabetes, even if a woman is otherwise slender.

"One's waistline is more important than BMI," Andersen said.

ActiveStyle on 05/18/2015

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