Stroke and Heart Attack In Women

Heart disease is the number one cause of death and disability of women in the United States. The most common cause of heart disease is the narrowing and subsequent blockage of the blood vessels, or coronary arteries, that supply the heart. As a woman ages, she is more likely to get heart disease. It is estimated that two-thirds of women who experience a heart attack do not to recover.

In general, women tend to believe that cancer is a greater threat than heart disease. This just is not the case. Two times as many women in the United States die of heart disease and stroke than from all other types of cancer, including cancer of the breast.

There are several factors that raise heart disease and stroke risk in women, as identified by The American Heart Association. Women have more risk factors for heart disease than men, and some of the risks you have no control over such as family history, age, and gender. These and other risk factors can be modified with treatment to control and lower the risks.

What heart disease risk factors can't be controlled?

Age: As a woman's age increases, so does her level of risk for heart disease.

Gender: Men are at greater risk and have heart attacks earlier in life than women. Women, who account for approximately 60% of all stroke deaths per year, have more strokes than men.

Family History: For both men and women, heart disease is more likely to occur if there is a close blood relative, such as a parent or sibling, an aunt or an uncle.

Race: Black women have a higher risk than white women for heart disease and stroke. Over all, African-Americans have a higher incidence of death due to stroke than that of their white counterparts.

History of heart attack or stroke: A woman who has a history of heart attack is at risk for having a second one; 22 percent of women ages 40 to 69 surviving a first heart attack will have another heart attack or fatal coronary heart disease within five years, and 22 percent ages 40 to 69 who survive a first stroke will have another within five years. A transient ischemic attack (TIA or "mini-stroke") also is a risk factor and predictor of stroke.

How can the risks be modified, treated or controlled?

Quitting Smoking: The most preventable cause of death in the US is smoking. It is the major cause of cardiovascular disease in women. Women have an increased risk for ischemic stroke (due to blockage) and subarachnoid hemmorhage (bleeding into the subarachnoid space) when they smoke or are constantly exposed to the secondhand smoke of others, even if she doesn't smoke. Women who use birthcontrol pills and smoke are also at an increased risk for heart disease.

Cholesterol Levels: A high serum, or blood cholesterol level is a major risk factor for heart attack and an important risk factor for stroke. Serum cholesterol below 200 mg/dL (milligrams per deciliter) is the desired total cholesterol level. At age 55 and up, cholesterol levels for women are higher than men. There are two types of cholesterol. The good cholesterol is called HDL (high-density lipoprotein). High levels of this lipoprotein lowers your risk for heart disease. High levels of bad cholesterol or LDH (low-density lipoprotein) increases the risk of heart disease and heart attack. Research shows that low levels of HDL cholesterol appear to be a stronger risk factor for women.

High blood pressure: A major risk factor for heart disease and stroke is Hypertension (HTN). Obesity in women increases this risk factor, as well as having a family history of high blood pressure, are pregnant, take certain types of birth control pills or have reached menopause. African-American women have higher average blood pressure levels than Caucasian women.

Lack of Physical Activity: Lack of physical activity is a risk factor for heart disease. Indirectly, it increases the risk of stroke. You are twice as likely to develop cardiovascular disease if inactive and eat too much, which causes you to gain excess weight. This can lead to high cholesterol levels, hypertension, diabetes, as well as increase the risk of heart disease and stroke. The American Heart Association recommends at least 30 minutes of physical activity on most or all days of the week. Before beginning any excercise program, be sure to consult with your physician. He can best advise you on the proper excercises to engage in.

Pot Bellies: Having too much weight around the mid-section, otherwise known as that "spare tire", carries a higher risk for health problems, including high blood pressure, high blood cholesterol, high triglycerides, diabetes, heart disease, and stroke.

Diabetes mellitus: Adults with diabetes have heart disease death rates that are two to four times those of adults without diabetes. People with diabetes often have high blood pressure and high cholesterol, and are overweight, increasing their risk even more.

Are there any other risk factors for heart disease and stroke in women?

Triglycerides: Triglycerides are a type of fat. High triglyceride levels many times go with higher levels of total cholesterol and LDL, lower levels of HDL, and increased risk of diabetes. A triglyceride level of less than 150 mg/dL is considered normal. However, scientists do not agree that tryglyceride alone is a risk factor. According to research, high tryclyceride levels in women are more of a risk factor than it is for men.

Alcoholism: Excessive use of alcohol (ETOH) and binge drinking can contribute to obesity, high triglycerides, cancer and other diseases including hypertension, cause heart failure, and lead to stroke. Pregnant women should not drink alcohol at all. The risk of heart disease in people who drink moderate amounts of alcohol (an average of one drink for women per day) is lower than in nondrinkers.

Stress Response: Each person responds differently to stress. While it is not yet fully understood the role stress plays in developing heart disease, how you respond to stressful situations, such as overeating or smoking, can be unhealthy and have an adverse impact on your overall risk for heart disease and stroke.

By Barb Hicks, RN/LMT