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Silent Risk: Women and Heart Disease

Heart disease kills half a million American women each year. So why are women more afraid of breast cancer?

Physicians' Attitudes: Part of the Problem? continued...

She says he couldn't believe what he was seeing and perhaps had preconceived notions about young women and heart disease. "I don't know how much it was a feminist issue or his frustration at not being able to get me well," she says.

Kastan remained ill following double bypass surgery. "Friends started wondering if some of this was in my head," she says. She contacted WomenHeart for support and was urged to go to a women's heart clinic. She went to Hayes. "She listened. She may challenge me, but she always supports me. She'd never question me as an intelligent human being or question my feelings."

Obstacles to Recovery

Here's something else you may not know: women who have heart attacks may not recover as quickly or as fully as men. In the survey, 52% of the women were unhappy with their medical care, and faced major hurdles getting the help and support they needed for recovery.

Following her bypass surgery, Kastan couldn't walk without having chest pains. But she says her recovery began within a week after she went to the women's heart clinic.

One study has shown that 35% of women compared to 18% of men have a second heart attack within six years of the first. "We don't completely understand that, but we have theories," Hayes tells WebMD. "We know women are not treated as aggressively as men after a heart attack. They're less likely to be on statins or ACE inhibitors or beta blockers, all of which reduce the risk of a second heart attack. Women receive fewer angioplasties and bypass operations and even less aspirin."

Is the disparity due to a true sex difference or because women are undertreated? The only way to find out, says Hayes, is for doctors to "start treating women the same as men."

The Take-Home Message

Kastan, who speaks around the country about women and heart disease, has seen doctors' attitudes improve in the past couple of years. "They're more aware of women and heart disease and aren't dismissing women as readily," she says.

She urges women to pay attention to their bodies and become more active consumers of health care. "I was uncomfortable going to the Mayo Clinic [for a second opinion] because I didn't want to hurt my cardiologist's feelings," she says. "That shouldn't have been my concern. Be your own best advocate."

Hayes says momentum for change is rising due to recent health campaigns and research results. "We've got a snowball going," she says. "More people are aware. Whether they're taking action is another issue."

She wants women to know they're more likely to die of heart disease than anything else. It's important to know the risk factors and symptoms, and take preventive steps.

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