Why is it important for women to learn about coronary artery disease?
Coronary artery disease is a leading cause of death for women throughout the world. More women die from heart disease than from cancer, chronic obstructive pulmonary disease, Alzheimer's, and
But many women underestimate the threat coronary artery
disease (CAD) poses to their health. And many women do not know what they can
do to help prevent heart disease.
Atherosclerosis is sneaky. It's a process that starts early in life, progressing silently. By the time symptoms occur, atherosclerosis is advanced and represents a serious problem.
There are tests for diagnosing atherosclerosis, but none of them are perfect. Some of them even have some risk of harm. So testing isn't as simple as you might think.
If you're concerned about atherosclerosis, what should you do? What can you expect at the doctor's office if you ask about an atherosclerosis diagnosis?...
disease is caused by the gradual buildup of
plaque (made of fat,
cholesterol and other substances) on the inside walls
coronary arteries. These arteries supply oxygen-rich
blood to the heart. Over time, the plaque deposits grow large enough to narrow
the arteries' inside channels, decreasing blood flow to heart muscle. If the
plaque becomes unstable and ruptures, a blood clot can form at the rupture site
and block blood flow, resulting in a
heart attack. See a picture of
how plaque causes a heart attack.
What factors lead to coronary artery disease in women?
Women have unique risk factors for heart disease. These risk factors include hormone replacement therapy, birth control pills, and pregnancy-related problems.
Menopause. A woman's chance of getting coronary artery disease is higher after menopause. This higher chance is not completely
understood. But cholesterol,
high blood pressure, and fat around the abdomen-all
risk factors for coronary artery disease-also increase around this time.
Hormone replacement therapy. Taking
estrogen with or without
progestin does not prevent coronary artery disease. In
fact, if you are 10 or more years past menopause, taking
hormone therapy may raise your risk of coronary artery
Birth control pills. Using birth control pills might
increase your risk if you smoke and are older than 35 or if you have a family
atherosclerosis or blood-clotting disorders.
Pregnancy-related problems. A problem during pregnancy called preeclampsia has been linked to a higher risk of heart disease later in life. Experts are studying whether other pregnancy-related problems are linked to heart disease. Tell your doctor about any problems you had during pregnancy.
Immune diseases. Some immune-related diseases, such as lupus and rheumatoid arthritis, have been linked with a higher risk of heart disease in women.
Heart disease risk factors for both women and men
The risk factors for coronary artery disease that are common in women and men include
smoking, diabetes, obesity, lack of exercise, and
How will my doctor determine my risk for coronary artery disease?
Your doctor will calculate your risk for coronary artery
disease by assessing the number of risk factors you have. Risk factors
Interactive Tool: Are You at Risk for a Heart Attack?
What can women do to prevent coronary artery disease?
Women can use healthy lifestyle changes and medicines to help prevent
coronary artery disease. Women can also balance the risks and benefits of
hormone replacement therapy when they decide whether or not to use it.
A healthy lifestyle can help prevent heart disease. And it can help you manage other problems that raise your risk of heart disease. These problems include high blood pressure, high cholesterol, and diabetes.
Eat a heart-healthy diet, which focuses on adding more healthy
foods to your diet and cutting back on foods that are not so good for you. Heart-healthy eating plans include the:
American Heart Association Healthy Diet.
Be active. Try to do
moderate activity at least 2� hours a week. Or try to
vigorous activity at least 1� hours a week. It's fine
to be active in blocks of 10 minutes or more throughout your day and
week. Do strength exercises at least 2 days a week. For more information, see the topic:
body mass index (BMI) between 18.5 and 24.9 and your
waist circumference less than 35 inches. To check your BMI:
Interactive Tool: Is Your BMI Increasing Your Health Risks?
If you drink alcohol, do so in moderation (an average of 1 drink a
day for women). If you do not drink, don't start.
You might take medicines, along with making healthy lifestyle changes, to lower your risk of heart disease. If you already have heart disease, medicine can help you prevent a heart attack or stroke. You might take:
High blood pressure medicine.
High cholesterol medicine.
Aspirin. Your doctor may suggest that you take a daily, low-dose
aspirin if the benefits of aspirin to prevent a stroke are greater than the
risk of stomach bleeding from taking daily aspirin. But the daily use of
low-dose aspirin in healthy women who are at low risk of stroke is not
An anticoagulant, also called a blood thinner, to lower your risk of stroke if you have atrial fibrillation.
Medicine to lower the workload on your heart. If you have been diagnosed with CAD or have had a heart attack,
you will probably take heart medicines like
beta-blockers, angiotensin-converting enzyme (ACE)
inhibitors, or angiotensin II receptor blockers (ARBs).
Talk to your doctor about your
risks with hormone therapy. And carefully weigh the
benefits against the risks of taking it. If you need
relief for symptoms of menopause, hormone therapy is one choice you can think
about. But there are other types of treatment for problems like hot flashes and
sleep problems. For more information, see the topic
Menopause and Perimenopause.
What are symptoms of coronary artery disease and heart attack?
Knowing symptoms of a heart attack can help save lives.
So even if you're not sure that your symptoms are from a heart attack, do not
delay seeking care. Do not wait more than 5 minutes to call
911 if you think you or someone else is
having a heart attack.
Women are more likely than men to delay seeking help for a possible
heart attack. Women delay for many reasons, like not being sure it is a heart
attack, or not wanting to bother others. But it is better to be safe than
sorry. If you have symptoms of a possible heart attack that last for 5 minutes,
call 911 right away.
Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a type of chest pain or
discomfort that occurs when there is not enough blood flow to the heart.
Pay attention to your symptoms, know what
is typical for you, learn how to control it, and know when to call for help.
Symptoms of angina include chest pain or pressure, or a strange feeling in the chest. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
Stable angina occurs at predictable times and may continue without much change for years.
It is relieved by rest or nitrates (nitroglycerin) and usually lasts less than
5 minutes. Unstable angina is a change in the usual pattern of angina. It means blood flow has slowed suddenly. It is an emergency. It is a warning sign that a heart attack may soon occur.
Heart attack symptoms
Chest pain or pressure, or a strange feeling in the chest
For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms like shortness of breath, nausea, and back or jaw pain.
After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
get to the hospital, do not be afraid to speak up for what you need. Be sure
your doctors know that you think you might be having a heart attack so that you
can get the tests and care you need.
Roger VL, et al. (2010). Heart disease and stroke statistics 2011 update: A report from the American Heart Association. Circulation, 123(4): e18-e209.
Rossouw JE, et al. (2007). Postmenopausal hormone
therapy and risk of cardiovascular disease by age and years since menopause.
JAMA, 297(13): 1465-1477.
U.S. Preventive Services Task Force (2009).
Aspirin for the Prevention of Cardiovascular Disease.
Rockville, MD: Agency for Healthcare Research and Quality. Available online:
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
John A. McPherson, MD, FACC, FSCAI - Cardiology
April 22, 2011
WebMD Medical Reference from Healthwise
April 22, 2011
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