Ask The Expert: The Myths and Facts about Women and Heart Disease
February is Heart Health Month, and while you may see people wearing red for “National Wear Red Day” on February 7th, there is more to the month than gimmicks and dress-up days. Heart disease is the number one killer is the U.S. for both men and women, but there is a lot misinformation out there. We asked Dr. Malissa Wood, clinical cardiologist and staff physician at the Cardiac Ultrasound Laboratory at Massachusetts General Hospital to separate fact from fiction.
Myth: Heart disease is always genetic.
Fact: Cigarette smoking, diabetes, hypertension, obesity, and hyperlipidemia are other factors that contribute significantly to heart disease risk, Wood says. “In fact, cigarette smoking is the single most preventable cause of coronary artery disease (blockages in the arteries). The important message here is that heart disease is preventable,” she says. “By managing blood pressure and cholesterol, eating right and losing weight if overweight, quitting smoking and increasing physical activity, women with these risk factors can greatly reduce their chance of developing heart disease.”
Myth: Breast cancer is more deadly to women than heart disease.
Fact: “Heart disease greatly outweighs breast cancer risk,” Wood says. “More woman die from heart disease than from the next four causes of death combined.”
Myth: Estrogen protects women from heart disease.
Fact: “While estrogen is very beneficial in relieving menopausal symptoms, it can actually increase risk of heart attack in women,” Wood says. “Estrogens should not be prescribed to prevent heart disease in women. If you are having menopausal symptoms such as hot ﬂashes, it is important to discuss your individual situation with your physician.”
Myth: It is common for women to have a second attack from being depressed after their bypass.
Fact: Wood says that depression does increase heart disease risk in women who have had a heart attack, although this does not occur commonly. “It is imperative that women seek either counseling or medical treatment or both when depression sets in,” she says. Depression can lead to other unhealthy behaviors including inactivity, overeating and excessive alcohol use, which can compound the problem.”
Myth: My healthcare provider will perform heart-related checks at my annual checkup.
Fact: Wood says that heart disease risks are not an automatic part of the annual exam for all physicians. “While physicians are very adept at ordering mammograms and Pap smears, evaluation of cholesterol, blood pressure, blood glucose, and weight are not always measured,” Wood says. “Remind your physician to provide you with these numbers if they do not do this. It is very important to know your numbers.”
Myth: I have to exercise at a gym for at least an hour to gain heart health benefits.
Fact: While any form of physical exercise is beneficial, Wood suggests walking, swimming, jogging, bicycling, or tennis. “It is recommended that women engage in at least 75 minutes of vigorous-intensity physical activity or 150 minutes of moderate-intensity physical activity (or an equivalent combination) every week,” she says. “Keeping a regular schedule and having to be accountable to your buddy increases the likelihood of maintaining a regular exercise schedule.
Myth: I’ve heard that there are heart attack symptoms specific to women. What should I be looking out for?
Fact: Wood says that women are more likely to experience unusual or atypical symptoms of heart disease including neck, jaw or arm pain, fatigue, and shortness of breath with activity. “If a woman experiences symptoms such as these that are new and recur, she should see her physician and have an evaluation. If a woman develops arm, neck or chest discomfort that does not quickly resolve, she should call 911,” Wood says.
Myth: If you have a clean EKG/stress test, nothing is wrong with your heart (referring to the vascular side of heart disease).
Fact: “This is false,” Wood says. “Women can have disease involving the small vessels of the heart that can result in chest pain and may not be picked up by an EKG or routine stress testing. If this is thought to be the case, your physician will emphasize the importance of treating all the standard heart disease risk factors and will likely encourage you to increase your physical activity. The higher the level of activity a woman achieves on a treadmill, the lower her risk of heart attack and death from heart disease.”
Myth: Heart disease and stroke aren’t related.
Fact: Heart disease and stroke are in fact related, Wood says. “Both are forms of vascular or blood vessel disease and either increases the risk of the other being present in a woman. Heart attack and stroke can occur in the presence of atherosclerosis, or hardening of the arteries,” she says. “This process can be slowed significantly by controlling risk factors and taking medications as prescribed by your physician.”
Myth: If you’re young, you’re safe from having a heart attack.
Fact: “This is also false,” Wood says. “Given the epidemic of obesity and inactivity in addition to other risk factors, heart attacks do occur in younger women. The risk of dying after a heart attack is higher in women than it is in men. One problem with young women is that they are often perceived as not being at risk for heart disease; thus, their symptoms may often be discounted by healthcare providers.”