Women: Listen to your heart

Quick question: What disease kills the most women every year? Strokes? Lung disease? Alzheimer’s? Breast cancer? Lung cancer? Nope, it’s heart disease—in fact, heart disease is more lethal to women than ALL cancers combined. And it kills three times more women each year than either lung disease, stroke or Alzheimer’s.

So why do people think of heart disease as a “man’s illness?” There are probably several answers to that question, but the most likely is that coronary heart disease tends to strike women about 10 years later than it does men. This is why we have different cutoffs for determining what ages are considered “premature heart disease” in women and men. But because women live longer than men, the numbers of women having heart attacks gradually catches up with men in older age groups.

What can you do to prevent coronary heart disease? 

1. Know the risk factors of coronary heart disease including family history. 

2. Keep your blood pressure and cholesterol under control. 

3. Eat a healthy diet that minimizes your risk of diabetes. 

4. Don’t smoke! That includes vaping. Need help? Talk to your primary care doctor about support you can get to stop smoking. 

5. Exercise!  In fact, exercise is not only beneficial in lowering a woman’s risk of a heart attack, but also has separate benefits in lowering her risk of heart failure.

What about Hormone Replacement Therapy?

One common question that I am asked is whether to start/stay on HRT (hormone replacement therapy). Based on the observation that women don’t tend to have heart attacks until after menopause, it was believed that estrogen was the protective factor and that it should be given to post-menopausal women to prevent heart disease from developing. However, large studies failed to demonstrate a benefit and actually suggested some cardiac harm in the first few years of using it. My advice is that it is generally OK to continue HRT if a woman has been on it for years without any problems. And if a woman has severe post-menopausal symptoms and HRT is felt to be the best way to treat them, then it is OK to start HRT.  Women at higher risk of having heart problems, though, should be carefully monitored. But it has definitively been disproven that a woman should start HRT for the purpose of preventing heart problems.

Listen to your heart

Another piece of advice, women: Listen to your heart. Don’t ignore symptoms, even if they don’t seem severe. Symptoms of heart problems can be different in women, particularly older women, where the classic chest pressure may not be present. Heart problems can be suggested by a vague discomfort in the chest or only occur in the jaw, shoulder or arms.  Sudden shortness of breath may be all that a woman notices who is experiencing a heart attack.

And women are often busier caring for their family—their partners, children, parents—and don’t pay enough attention to their own health. So, again, take care of yourselves. Pay attention to what your body is telling you. And don’t assume that being female protects you from having heart disease. Heart problems are a threat to women, too, not just men.

Greg Koshkarian, MD, FACC

Dr. Koshkarian has been fascinated by the cardiovascular system since he began his medical training in 1985 at Yale University School of Medicine and is Board Certified in Cardiology. Dr. Kosharian shares "The rewards of caring for the cardiac patient have been immense. I have had the privilege (up until 2017) to be an interventional cardiologist, using those skills to stop heart attacks in their tracks by opening up a clogged artery with balloons and stents. But it is the teaching opportunities—both with hospitalized patients and those in the office—that I have found over the years give me the greatest career satisfaction." He enjoys helping patients learn about heart disease—how it starts, how it progresses, and what a person can do to gain control over that process. Dr. Koshkarian is a cardiologist with Pima Heart and Vascular

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