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Heart Attacks Hit Middle-Aged Women

Heart attack risk is rising in U.S. women -- decades earlier than you might expect. Find out why, and what women can do about it.
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"I never thought it could happen to me."

That's how Rose Rench reacted when doctors told her she was having a heart attack. At age 46, Rench was bewildered when she suddenly couldn't catch her breath while out for a walk on a sunny spring day. "I was young, I was 130 pounds, and I'd quit smoking a month before. I was healthy. But I couldn't breathe."

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Rench tells WebMD that she somehow drove herself home, but couldn't rest; her mind raced as she tried to gasp for breath. "I thought maybe I was having an asthma attack, though I’d never had asthma before. But I never thought of a heart attack," she says.

Rench drove herself to the emergency room, where tests showed an 80% blockage in two of the arteries bringing blood and nutrients to her heart. She immediately underwent a procedure to open those clogged arteries and keep them open with stents, which are tiny mesh tubes used to treat blockages. 

Rench's story isn't as rare as you might think. A recent study shows that heart attacks are rising among middle-aged women, who have long been thought to be protected against heart disease -- at least until they reach menopause and lose the protective effect of the hormone estrogen.

What's behind that alarming trend -- and what can women do to protect themselves from having a heart attack in middle age? The answers, heart experts tell WebMD, are all about raising awareness and taking action.

Heart Attacks Rising in Middle-Aged Women

Here's a quick look at the rising heart attack rate among middle-aged U.S. women.

That trend, reported in 2009, is based on more than 8,000 U.S. men and women aged 35-54 studied between 1988-1994 and 1999-2004.

During both time periods, heart attacks were more common among men than women. But men's heart attack rate dropped from 2.5% to 2.2%, while women's heart attack rate rose from 0.7% to 1%.

In short, heart attack rates headed down for men, and up for women.

Why? Men had a few things going for them. Their blood pressure dropped, their HDL ("good") cholesterol improved, and they were less likely than women to smoke.

"The lower rates of smoking, improved blood pressure levels, and improved HDL among men suggest that educational campaigns aimed at men are working," says researcher Amytis Towfighi, MD, of the University of Southern California.

But women showed only one positive trend: an improvement in their HDL cholesterol level. They also had two major drawbacks: a higher rate of smoking and an uptick in diabetes, most likely because of obesity.

Heart Attack Hazard: Obesity

About 35% of U.S. women are obese, according to the CDC. And those extra pounds pack a cardiovascular threat.

"We used to think obesity was a risk factor simply because it is associated with established risk factors such as high blood pressure and diabetes and high cholesterol levels. But now we recognize that by itself, it increases risk," says Martha L. Daviglus, MD, PhD, professor of preventive medicine and medicine at Northwestern University's Feinberg School of Medicine in Chicago and spokeswoman for the American Heart Association.

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