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Heart Disease In Women - Know Your Risk

Barbara at home in her living room,
planning a trip.

When asked to name family members affected by heart disease, most people think of Uncle John, Cousin Bob or possibly their own father. A common belief is that heart disease only affects men--perhaps because men are diagnosed with heart disease roughly 10 years before most women. A recent study showed that only 13 percent of women considered heart disease to be their greatest health risk. In fact, women are six times more likely to die of heart disease than of breast cancer, reports Karen Buri, a registered nurse with North Kansas City Hospital's Cardiac Rehab Program. "We see women in their early forties affected by heart disease."

Health professionals now believe that coronary artery disease (CAD) can begin early in life with inflammation of the delicate lining of arterial walls. This process leads to the development of plaque. Because women have small blood vessels, even a minimal amount of plaque can cause a blockage or lead to a heart attack.

Risk Factors

The following risk factors greatly increase a woman's chance of this inflammatory process and the development of CAD:
  • After menopause the cardio-protective effect of natural female hormones is lost. In addition, aging leads to increased bad cholesterol (LDL), decreased good cholesterol (HDL), changes in blood vessel walls, and increased fibrinogen levels (a substance that causes blood to clot).
  • Smoking just one to four cigarettes a day doubles a woman's chance of having a heart attack. Exposure to second-hand smoke as a child also can begin this inflammatory process.
  • Women with diabetes have lower HDL cholesterol, are usually overweight and have a greater risk for developing blood clots.
  • Abdominal obesity (a waist circumference of 35 inches or more) is associated with higher triglycerides, higher LDL cholesterol, lower HDL cholesterol and a greater risk of diabetes.  
  • Physical inactivity contributes to high blood pressure, high cholesterol and obesity.
  • Chronic stress increases blood pressure. The stress hormone cortisol damages blood vessels, increases cholesterol levels and leads to overeating.


Symptoms that occur for weeks or months before a heart attack include:
  • Unusual fatigue
  • Sleep disturbance
  • Shortness of breath
  • Chest discomfort
  • Indigestion
  • Anxiety
  • Pain in the upper back

Women often describe their chest symptoms as pressure, tightness or an ache rather than pain. Many heart attack patients, especially women, wait two hours or more after their symptoms begin to seek medical help which delays lifesaving procedures.

At 63 years of age, Barbara Willt has dealt with heart disease for several years, initially through stents placed to open her arteries and most recently with bypass surgery. She encourages women to see their doctor if they don't feel well. "Don't ignore any symptoms," she says. "My symptoms of throat and jaw discomfort weren't typical, but together with shortness of breath and arm pain, I knew something was wrong."

The good news is that even if a woman has a family history, there is a great deal that can be done to prevent heart disease. The Cardiac Rehab Team at North Kansas City Hospital encourages everyone to stop all forms of tobacco, avoid second-hand smoke, exercise daily, monitor blood pressure levels and know lipid profile results. By making their own health a priority, women can better meet the demands of their busy lives.

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  • Heart Disease in Women - Know Your Risk