Heart disease is the leading cause of death in women in the United States. Today in the U.S., one in three women is living with some form of cardiovascular disease. Fortunately, the American Heart Association is looking to change that statistic because 80 percent of cardiac and stroke events may be prevented with education and action.
Regrettably, because the symptoms of a heart attack in women are often significantly different than those in men, they sometimes go undetected and untreated. Specifically, women often experience shortness of breath, nausea, vomiting and back or jaw pain. Sometimes the signs are subtle, but the consequences can be deadly, especially if the woman does not seek help right away.
February is American Heart Month, a time when people are reminded to take good care of their hearts. According to preventive cardiologist, Jason Reingold, MD, FAAC, with Holistic Heart Center at Georgia Cardiovascular, there are three especially critical points in a woman’s life when she needs to pay close attention to her heart – during pregnancy; at middle age, especially if she has been diagnosed with an auto-immune or chronic inflammatory disease such as rheumatoid arthritis and inflammatory bowel disease; and during menopause.
Reingold points out that research suggests that 70 to 75 percent of people who have a heart attack would have been classified as low risk by traditional methods of risk assessment. Furthermore, data warns that 50 percent of people who have a heart attack will not experience symptoms or do not recognize what they are experiencing. Women, in fact, frequently attribute the symptoms of a heart attack to reflux, indigestion, aging or the flu and delay seeking treatment. In addition, women who suffer a cardiac arrest in public are less likely to receive CPR from bystanders due to a fear of hurting the person or facing legal consequences.
With advances in medicine, today there are several tests available to diagnose heart disease at an earlier, pre-clinical stage to prevent future complications. A simple saliva swab test can unlock genetic markers that raise one’s risk of heart disease, similar to the use of BRACA testing in Jewish women with breast cancer. In addition, blood-based biomarkers allow for the identification of abnormal metabolic processes such as inflammation and immune system activation that are the root cause of plaque buildup in arteries.
Imaging using ultrasound, which emits no radiation, or a CT scan will identify the earliest accumulation of plaque buildup in the arteries. Especially for women in their 30s and 40s, identifying the buildup allows for lifestyle changes before intervention may be necessary. Sometimes these tests are covered by insurance and even when not covered, the out-of-pocket costs are generally affordable.
Reingold may utilize these tests in his practice for women who have a family history of premature heart disease, complications of pregnancy such as preeclampsia or diabetes, autoimmune or chronic inflammatory conditions such as rheumatoid arthritis and inflammatory bowel disease, or are at immediate risk, based on traditional risk factors.
Leading up to, during and following pregnancy, women need to pay attention to their heart health. One in five women is clinically obese before becoming pregnant, increasing the risk of heart complications during pregnancy. Also, more than half of women enter pregnancy with a risk factor for cardiovascular disease, many without being diagnosed beforehand. These risk factors include a buildup of plaque in the arteries, high blood pressure, arrhythmia or an abnormal heart rhythm or heart valve problems. Overall, 10 to 20 percent of women will have a health issue during pregnancy. Taking care of the heart before conception is important to help ensure a healthy outcome. Managing weight and underlying conditions such as high blood pressure or high cholesterol can significantly reduce the risk of problems and help ensure that mother and baby stay safe and healthy.
Autoimmune conditions are another important factor to consider when assessing women in their 30s and 40s for heart disease. The Sept. 3, 2022 issue of The Lancet, a medical journal, reported on a study that looked at 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the United Kingdom. Researchers found an increased risk of cardiovascular disease that grew progressively with the number of autoimmune diseases for each person. The study was conducted on patients under 55 years old with heart disease.
As women enter and go through menopause, cardiovascular risk factors often increase. According to the American Heart Association, women who reach menopause before age 45 have a significantly higher risk of coronary heart disease. Also, with little or no estrogen production following menopause, cholesterol may begin to build up on artery walls. A buildup in vessels leading to the heart or brain can increase the risk of heart disease or stroke.
Other risks for heart disease during and following menopause include sleep issues, increased visceral fat around the midsection, higher cholesterol levels and a diagnosis of metabolic syndrome, made when a person has three or more individual risk factors (abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure and high blood sugar). Scheduling a visit with a preventive cardiologist at this time is important to maintain good heart health and detect any underlying heart conditions.
Though rates of heart disease have increased in younger women in recent years, Reingold suggests prevention through earlier detection, especially for women with a higher risk factor. He also suggests women follow the “Essential 8,” developed by the American Heart Association. “Eat better. Be more active. Quit Tobacco. Get Healthy Sleep. Manage Weight. Control Cholesterol. Manage Blood Sugar. Manage Blood Pressure,” he said. “And in addition to these steps, I also encourage everyone to take “My Life Check” to start the journey toward optimal health,” he added. “My Life Check” is a health assessment and improvement tool built by the American Heart Association to encourage people to form healthy habits that move them toward ideal heart health, lowering the risk for cancer, diabetes, and depression and improving cognitive function.
American Heart Month began in 1964, at a time when heart disease was becoming a crisis for Americans. Go Red for Women, the American Heart Association’s signature initiative for women, was introduced in 2004 and is a comprehensive platform designed to increase women’s heart health awareness and serve as a catalyst for change to improve the lives of women across the globe. Today, Go Red for Women not only advocates for the health of all women, funds lifesaving research and educates women across the United States and around the world, but is also committed to removing the unique barriers women face to experiencing better health and well-being.
The Holistic Heart Center at Georgia Cardiovascular combines traditional diagnostic and treatment methodologies with integrative approaches. Dr. Reingold graduated from Emory University School of Medicine and trained at Massachusetts General Hospital/Harvard Medical School. For more information, visit www.drjasonreingold.com.
- Health and Wellness
- Debbie Diamond
- Heart Disease
- American Heart Association
- American Heart Month
- Jason Reingold
- Holistic Heart Center at Georgia Cardiovascular
- rheumatoid arthritis
- Inflammatory Bowel Disease
- CT Scan
- The Lancet
- United Kingdom
- Go Red for Women
- Emory University School of Medicine
- Massachusetts General Hospital/Harvard Medical School