Heart Disease: A Leading Killer Of Women

By Jan Howard

Women are often uninformed or misinformed about their risk of heart disease. After all, women don’t get heart disease, right? Wrong. For years, women, and some doctors, too, have believed that heart disease strikes men, not women. However, contrary to those beliefs, heart disease is a leading killer of women in the United States.

Each year, about one half million American women die of cardiovascular disease. Of this number, 235,000 women die from heart attacks.

A book, co-authored by a Southbury woman and an internationally recognized cardiologist, tells women what they can do to help prevent heart disease.

The Women’s Heart Book: The Complete Guide to Keeping Your Heart Healthy, by Charlotte Libov and Dr Fredric J. Pashkow, medical director of the Queens Medical Center Heart Institute in Honolulu, Hawaii, originally published in 1993, has been completely revised and updated and was released in February by Hyperion.

For years, men have been warned of the threat of heart disease. From the late 1800s, it has been described as a male disease. Because women tend to contract coronary heart disease later in life than men do and were retired or homemakers, they were not visible in society. Most of the research on heart disease has been centered on men.

“Doctors weren’t aware, and women weren’t aware,” Ms Libov said recently. “It probably led to needless deaths.” She notes that many times when women would complain of chest pains, they would be told, “It’s all in your head,” or due to nerves or stress. “It still happens.”

Books, articles, and even TV commercials convey the impression that heart disease only strikes men, not women. A 1996 Gallup survey of primary care doctors polled said breast cancer and osteoporosis were greater threats to women than heart disease.

Ms Libov said that women’s heart problems are still not being adequately addressed. “They had to play catch-up. It is a big killer – twice as many as cancer and five times the number of women who die from breast cancer,” she added.

Women also have a tendency to blame their symptoms on getting older or gaining weight, Ms Libov said. “As a whole, women tend to look more inwardly for reasons.”

The main message, Ms Libov said, is that while women are focusing on the threat of breast cancer, they are missing opportunities to know about preventing heart disease. “Women are missing opportunities to be more healthy,” she noted. “Smoking is a huge cause of heart problems in women.”

Women’s symptoms of heart disease may be different than those of a man. They might have more chest pain or irregular heartbeats, Ms Libov said.  “Women also have a higher threshold for pain than men,” she added.

Women are also more at risk right after a heart attack, and coronary surgery remains riskier for women than men, which is also true of balloon angioplasty and other procedures used to treat coronary heart disease.

She encouraged women to be specific if they feel they are having a heart attack. “Don’t say maybe. If you believe you’re having a heart attack, you want to be taken seriously.”

When women suffer heart attacks, they often fare worse than men do. According to Ms Libov’s book, younger women who have heart attacks are more likely to die from them than men of the same age. “Younger women are still not taken seriously for heart attack,” she said.

Ms Libov said there are conflicting studies on the care women receive once they are diagnosed with heart disease. “Some studies still show bias, that women don’t get the same care as men.”

Ms Libov has first-hand experience about heart disease in women. She is a survivor of open-heart surgery. In 1990, at the age of 40, she was diagnosed with a congenital heart condition, an atrial septal defect, and a hole in her heart, which she had had since birth.

“I had no idea there was anything wrong with me,” Ms Libov said, noting she was never sent to a cardiologist, despite having a significant heart murmur. “I didn’t know women had heart problems. It was discovered by chance because I went to a crackerjack internist.”

Though there was a lot of news about heart problems, there were no books on the heart problems of women. “I looked everywhere. There were no books tailored for women. They were tailored for 55-year-old white males. I knew the topic was more huge than that.”

Subsequently, she linked up with Dr. Pashkow, her cousin, to write The Women’s Heart Book.

Some of the risk factors for heart disease include age, family medical history, race, smoking, oral contraceptives (if a smoker), abnormal cholesterol pattern, diabetes, sedentary lifestyle, weight, and high blood pressure/hypertension.

Ms Libov stressed the importance of knowledge, of knowing your risk factors.

Some issues discussed in the book include calculating the risk for heart disease, finding a good doctor, detecting congenital defects, what a pregnant woman should know about potential heart problems, and state-of-the-art treatments, surgeries, and drug therapies.

Also included is an effective diet and exercise plan that can reduce the risk of heart disease. The book also offers helpful advice with lifesaving and mind-saving tips.

A more sophisticated test for cholesterol is on the horizon, Ms Libov said. “Eventually there will be more individualized programs. The testing that is going on is good.” She said women should know their ratio of HDL (the good cholesterol) and LDL (the bad cholesterol).

“There are new developments that we will be hearing more and more about,” she said.

Ms Libov encourages women to take a proactive approach. “If you take care of your heart, you’re taking care of your body.” Women of all ages need to be more assertive with their doctors. They also have to recognize their symptoms themselves, she added.

“The myth of heart attack, lung cancer, and colon cancer being men’s diseases are myths that take a long time to dislodge,” she said.

She said women should stop smoking, adopt a healthier diet that is low in saturated fat, and exercise moderately. “I’m not big on deprivation,” she said. “Some people embrace a Spartan diet.”

She said the “bloom is off the rose” regarding hormone replacement. “It may not be as protective as was once thought.”

The changes women make in their lifestyles to reduce the risk of heart disease don’t have to be drastic, Ms Libov said, noting her book is filled with tips and tricks to make it easier.

“You can make a huge difference with a moderate loss of weight and lifestyle changes,” Ms Libov said. “It doesn’t have to be in draconian fashion.”

Ms Libov is the author of Beat Your Risk Factors: A Woman’s Guide to Reducing Her Risk for Cancer, Heart Disease, Stroke, Diabetes and Osteoporosis and Migraine: 50 Essential Things to Do.  She is the co-author with Dr Pashkow of 50 Essential Things to Do if the Doctor Says it’s Heart Disease. She also co-authored with Gabrielle Weiner, MS, Women and Heart Disease: A Special Report from the Editors of Women’s Health Advisor: The Center for Women’s Healthcare, Weill Medical College of Cornell University.

She has also been a freelance writer for such publications as The New York Times, Connecticut Magazine, Yankee Magazine, The Courant, medical publications, and others. She has also been employed as a newspaper bureau chief and reporter. She has won several awards.