Like Older Young Women Should be Aware of Symptoms of Heart Disease

Like Older Young Women Should be Aware of Symptoms of Heart Disease

"Make every mother and child count" is the slogan for World Health Day 2005. It reflects the fact that the health of women and children is not yet a high enough priority for many governments and the international community.Overweight children are three to five times more likely to suffer a heart attack or stroke before they reach the age of 65, warns the World Heart Federation, an NGO dedicated to the prevention of heart disease and stroke, on World Heart Day.

One in 2.5 women will die of heart disease or stroke, compared with one in 30 from breast cancer. But you can substantially reduce many of your risk factors for heart disease and stroke with a few simple lifestyle changes. And if you've already had heart disease or a stroke, the lifestyle changes can help you to a more successful recovery.Cardiovascular disease, including stroke, claims more women’s lives than the next six causes of death combined — nearly 500,000 a year, nearly twice as many as all forms of cancer.

Your risk of developing heart disease increases as you grow older; however, updated 2007 guidelines from the American Heart Association point out that a woman's risk of heart disease develops over her entire lifetime.

The most common warning sign of a heart attack in both men and women is chest discomfort – most heart attacks involve discomfort in the center of the best that last more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Women, however, are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain. This may not be accompanied by typical chest pain. Women are also more likely to report unexplained fatigue.

WHO has been alarmed by the increase in smoking and other forms of tobacco consumption by women and young girls worldwide and keeping in mind the need for full participation of women at all levels of policy-making and implementation and the need for
gender-specific tobacco control strategies.

According to CDC statistics show men are at higher risk of death than are women in most of these categories. As a result, the average American man lives 5.3 fewer years than does the average woman. In 2003, male life expectancy was 74.8 years. Female life expectancy was 80.1 years.Women are more likely to put on extra weight around the hips (pear-shape obesity). While unhealthy, this type of fat distribution is not linked as closely to potentially fatal conditions.

The exercise stress test, or stress ECG, may be less accurate in women. For example, in young women with a low likelihood of coronary heart disease, an exercise stress test may give a false positive result. In contrast, single-vessel heart disease, which is more common in women than in men, may not be picked up on a routine exercise stress test.

Many lifestyle-related risk factors for coronary heart disease have been identified.Among women, adherence to lifestyle guidelines involving diet, exercise, and abstinence from smoking is associated with a very low risk of coronary heart disease.Many of the factors were correlated, but each independently and significantly predicted risk, even after further adjustment for age, family history, presence or absence of diagnosed hypertension or diagnosed high cholesterol level, and menopausal status.

Studies show girls and women are more likely to fear weight gain than boys, and to initiate and continue smoking for weight control. Some surveys find women gain more weight after quitting than men (Kaufman and Nichter in WHO 2001; Aghi et al. in WHO 2001). Recent review articles agree women and girls tend to smoke as a “buffer” against negative feelings, while men smoke more from habit or to enhance positive sensations. Some studies among low-income mothers in Western countries found smoking was used as a “time out” from the demands of caring for young children .

In spite of estrogen's benefits on cholesterol levels and other factors that affect the heart, evidence suggests that Hormone Replacement Therapy (HRT) does not prevent heart disease. In fact, it may actually be harmful for women with existing heart disease, at least in the first few years, and may also worsen the outlook after a heart attack.Studies have reported a slightly increased risk of stroke in women taking HRT within the first two years of treatment and in HRT users with a history of major stroke or small strokes (transient ischemic attacks). A 2005 review found that HRT increased the risk of stroke, particularly ischemic (a type of stroke caused by an interruption in blood flow to part of the brain) stroke. In addition, HRT appears to worsen the outlook for women who have had a stroke.

Since women tend to have heart attacks later in life than men do, they often have other diseases (such as arthritis or osteoporosis) that can mask heart attack symptoms. Increased age and the more advanced stage of coronary heart disease in women can affect treatment options available to physicians. Increased age also can help explain women's greater mortality after heart attacks.

Most women 55 years and younger who have heart attacks don’t recognize warning signs, researchers reported at the American Heart Association’s 8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

Women younger than 55 years represent less than 5 percent of all hospitalized heart disease patients, but because so many heart attacks occur in the United States each year, even this small percentage affects a large number of people. Young women with heart disease account for about 40,000 hospitalizations each year. Diseases of the heart in young women account for about 16,000 deaths annually, ranking it among the leading causes of death in this group, according to authors.

“The number of young women who die from coronary heart disease each year is roughly comparable to the number of women who die of breast cancer in this age group,” said Judith Lichtman, Ph.D., lead author of the study. “Studies have shown that young women with heart disease are twice as likely to die in the hospital as similarly aged men. While these statistics are startling, relatively little is known about the clinical presentation, care or outcomes of young women with heart disease.”

In a pilot study, Lichtman and colleagues studied 24 women (55 and younger) who had heart attacks and were admitted to one of two Connecticut hospitals. The researchers asked them about their symptoms before the heart attack and whether they recognized or understood that they were at risk for heart disease.

Nearly 90 percent of the women in the study had the typical heart attack symptom of chest pain, with 7.4 being the average rating of their chest pain on a scale of one to 10 (with 10 being the most painful).

“This means that they were experiencing significant chest pain,” said Lichtman, an assistant professor in the Department of Epidemiology and Public Health at Yale School of Medicine in New Haven, Conn.

Researchers said they were surprised that only 42 percent, or four in 10, of the women who came into the hospital thought something was wrong with their hearts. “Many of them told us that they thought they had indigestion or heartburn,” Lichtman said.

The women also reported other less typical symptoms:

Only about half of the women went to an emergency room within the first hour of their symptoms.

“When we asked the women why they delayed going to the hospital, half of those who waited more than an hour said they were afraid their symptoms weren’t real; about 42 percent attributed their symptoms to something else; about 17 percent said they were embarrassed by their symptoms; and 8 percent admitted that they feared the symptoms or experienced denial that it could be heart disease,” Lichtman said.

The researchers also found that about 88 percent of the women had a family history (a parent or sibling) with heart disease. Even though 71 percent said their health was fair/poor, less than half considered themselves at risk for heart disease.

The researchers said doctors may be failing to link many young women’s symptoms to heart disease. Prior to their heart attacks, 38 percent saw their primary providers for some or all of their symptoms; yet, only 56 percent of those women said their doctors told them their symptoms were heart-related.

“It seems that many young women are not connecting their symptoms with heart disease, even more are simply unaware of the possibility that they are at risk for a heart attack,” Lichtman said. “We have to get the messages across to young women that they are at risk for a heart attack, they might experience not only typical but also atypical symptoms, and they need to be aware of their own risk factors, including family history. Prevention and modification of risk factors is important for young women.”

To avoid possible permanent damage to the heart muscle, young women, like their older counterparts, must seek prompt care if they have symptoms. They also must be persistent with their health providers — especially if they have risk factors, including high blood pressure, high cholesterol, obesity, smoking, inactivity, diabetes and family history, Lichtman said.

A healthy heart is vital for living life to the full, regardless of age and gender. Unhealthy diets, physical activity and smoking are the leading causes of heart disease and stroke. These unhealthy behaviors are increasingly common among children and teenagers and are being adopted at an alarmingly early age. That's why World Heart Day this year is focused on how important it is for children, in all parts of the world, to have a heart for life.


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