Lifestyle changes are key in preventing heart disease in women.
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The Truth About Heart Disease One in two women dies of heart disease or stroke. One in30 dies of breast cancer. For more facts and tips, visit The Heart Truth, a national awareness campaign.
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Heart Disease and StrokeHeart disease is the leading cause of death for all American women and the number one killer of minority women in the United States. Nearly twice as many women in the United States die of heart disease and stroke as from all forms of cancer.1 |
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Heart DiseaseHeart disease is a disorder of the heart and blood vessel system. Coronary heart disease (CHD) is a disease of the blood vessels of the heart, known as “coronary arteries.” Coronary heart disease causes chest pain (angina) and heart attacks. When too little blood flows to the heart, angina results. When the blood flow is critically reduced, a heart attack occurs. Signs of a heart attack in women can be different than in men, so symptoms often go undiagnosed or are misdiagnosed. For example, other than chest pain, women may have nausea, dizziness, or unexplained weakness or fatigue without chest pain.2 Although the term heart disease can refer to any heart ailment, it is usually associated with coronary heart disease. Blocked arteries in the heart severely restrict the amount of blood that can flow to the heart. In turn, this insufficient blood flow deprives the heart muscle of much-needed oxygen and nutrients. When the blood supply is interrupted, the muscle cells of the heart suffer irreversible injury and die. This condition is known as a heart attack. |
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As shown in the chart Deaths for Women from Major Cardiovascular Diseases, African American females had the highest age-adjusted death rate from major cardiovascular diseases (more than 395.5 per 100,000) of all American females in 1997-1999. The death rate was 194.5 per 100,000 Hispanic females, followed by rates of 189.9 per 100,000 American Indian/Alaska Native females and 180.1 per 100,000 Asian and Pacific Islander females. |
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The major risk factors for heart disease include:2
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Heart disease affects specific population groups differently:2
Stroke
An obstruction, rupture, or other disorder in the blood vessels leading to the brain restricts the supply of oxygen to the brain. Insufficient oxygen to the brain usually results in a stroke. Cerebrovascular diseases can result in weakness, paralysis of some parts of the body, difficulties with speech, loss of consciousness, or death. Major risk factors for stroke are similar to those for heart disease, including smoking, high blood pressure, and high blood cholesterol. Stroke and other cerebrovascular diseases (which refer to the blood supply to the brain) are leading cause of death for minority women in the United States:2
High Blood PressureHigh blood pressure, also called hypertension, is a serious health condition that can lead to stroke, heart disease, kidney failure, and other health problems. As blood flows from the heart out to the blood vessels, it creates pressure against the blood vessel walls. A person’s blood pressure reading is a measure of this pressure. When that reading goes above a certain point, it is called high blood pressure. People are classified as hypertensive if:
Doctors believe many factors may cause high blood pressure, such as being overweight, drinking too much alcohol, and eating too much salt. Sometimes high blood pressure may be caused by other illnesses. Once the illness goes away, the person’s high blood pressure should go down. Black (non-Hispanic) or African American and Alaska Native women 20 years of age and older have higher blood pressure levels (36.4 and 36.0, respectively) than white non-Hispanic women (19.7 percent).3 African American women also are more likely to have serious problems as a result of their high blood pressure than white women are. These serious problems include stroke, heart disease, and kidney failure. Among all women, American Indian/Alaska Native women are the least likely to have had a blood pressure screening. A staggering 73 percent of American Indian/Alaska Native women had not had a blood pressure screening in the past 12 months. Of Hispanic and Asian American women, 26 percent and 27 percent, respectively, had not had a blood pressure screening in the past 12 months. In contrast, 20 percent of white women and 18 percent of African American women reported that they had not had a blood pressure screening.4 In terms of whether they have been told by a doctor, nurse, or other health professional that they have high blood pressure, Hispanic women experience significantly different regional hypertension rates. For example, as shown on the map Hispanic Women With Hypertension, the proportion of Hispanic women in Virginia is a low of 12.5 percent, compared to a high of 42.9 in Maine. The best treatments for high blood pressure are living a healthy life and taking medication as directed by a woman’s doctor. A woman can live a healthy life and control her blood pressure by:
The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure was developed using evidence-based medicine and consensus to make recommendations to clinicians. It provided a contemporary approach to hypertension prevention and control and included a discussion of drug therapies and a guide to help clinicians individualize treatment by stratifying patients’ risks. The report included a section on racial and ethnic minorities.4 After that report was released in 1997, many large-scale clinical trials were published. Work thus began on a seventh report that would include a practical guide and a more comprehensive report. The express volume now is available for primary care physicians, and the other volume is in progress. Of particular importance to women concerned about heart health is the new guideline for hypertension prevention and management. The classification “prehypertension” recognizes the relationship of blood pressure and heart disease and stroke. Women have even more reasons to make healthy choices for their hearts. High Blood CholesterolCholesterol is a fatty substance made by the liver and found in all parts of the body. The body uses cholesterol to produce hormones, vitamin D, and the bile acids that help to digest fat. It takes only a small amount of cholesterol in the blood to meet these needs; the liver makes all the cholesterol a person’s body needs.
High blood
cholesterol means that there is too much cholesterol (a fat-like
substance) in a person’s blood. The risk for getting heart disease
or having a heart attack goes up when the cholesterol level is too
high. If a person has high blood cholesterol, fatty deposits called plaque can build up on the walls of the arteries and cause atherosclerosis. If the arteries that carry blood to the heart (the coronary arteries) are affected, less blood and oxygen can get to the heart. This condition can cause chest pain (angina) and heart attacks. Heart disease is the number one cause of death for both women and men in the United States. High blood cholesterol levels raise a person’s chances of getting heart disease. Blood cholesterol levels in both men and women begin to go up around age 20. Before menopause, women have lower cholesterol levels than men of the same age. After menopause, a woman’s cholesterol level can go up. High blood cholesterol was found in roughly equal proportions of the subpopulations of women of color between the ages of 20 and 74 years in 1988-1994. About a fifth of white non-Hispanic (21 percent) and black non-Hispanic (20 percent) women reported having high blood cholesterol as did 19 percent of Mexican American females.5 As with other heart disease risk factors, regional differences are noted. For example, as shown on the map Black, Non-Hispanic Women Who Have Been Told They Have High Cholesterol, the proportion of black, non-Hispanic women who have been told they have high cholesterol ranges from a high of 42.5 in Nevada to 13.8 percent in Kansas. The Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults provides updated evidence-based clinical guidelines for cholesterol testing and management. Recommendations are included for women and racial/ethnic groups.6 In February 2004, the American Heart Association (AHA) announced new evidence-based guidelines for preventing heart disease and stroke in women based on a woman’s individual cardiovascular health. Published in Circulation: Journal of the American Heart Association, the guidelines represent a collaborative effort among AHA, the American College of Cardiology, and 10 other medical professional associations as well as Federal agencies. Another 22 organizations have endorsed the guidelines. The guidelines take a personal approach to preventing cardiovascular disease in women. A woman is classified in one of three risk levels (low, intermediate, or high risk of having a heart attach in the next 10 years). Each level has specific recommendations for lifestyle and medical interventions.
1 U.S. Department of Health and Human Services (HHS). The Health of Minority Women. Washington, DC: HHS, Public Health Service (PHS), Office on Women’s Health (OWH), 2000. 2 OWH. Health Information for Minority Women: African-American Women.
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Delgado, J.L., and Trevino, F.M. The state of Hispanic
health in the United States. 4 Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. 5 National Center for Health Statistics. Health, United States 2001 with urban and rural health chartbook. Hyattsville, MD: PHS, 2001. 6 Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. |
Last updated June 2004
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