TUESDAY, Feb. 15 (HealthDay News) -- Preventing heart attacks
and strokes is very similar in women and men, with a few small but
important differences, according to new guidelines from the
American Heart Association.
Each year, 55,000 more U.S. women than men suffer a stroke,
while men are more likely to have heart attacks.
One strong risk factor for stroke is atrial fibrillation, an
abnormal heart rhythm that boosts women's risk of stroke by
fourfold to fivefold. To prevent stroke, women should make sure
they have consulted with their doctor and are taking the right
medications to control atrial fibrillation, according to the
Women also have other unique risk factors that can increase
their chances of stroke, including pregnancy, taking birth control
pills, and hormone replacement therapy during menopause.
Certain pregnancy complications including preeclampsia (high
blood pressure and protein in the urine), preterm birth, having a
baby that's small for its gestational age and gestational diabetes
are associated with later heart problems -- something women and
their doctors often don't know.
"We consider pregnancy like a physical and metabolic stress test, and complications are like failing the stress test," said Dr. Lori Mosca, chair of the guidelines writing committee and director of preventive cardiology at New York-Presbyterian Hospital. "It's an early indicator of a problem, and there is a common mechanism between pregnancy complications and cardiovascular disease, which is metabolic and vascular dysfunction."
The new guidelines for preventing heart disease in women are
published online and in the March 21 print issue of
Heart disease is the No. 1 killer of women, yet only 54 percent
of women knew this in 2009, according to background information in
the report. Still, awareness is up substantially from 1997, when
only 30 percent realized heart disease wasn't primarily a "man's
disease," the authors noted.
And rising rates of obesity and diabetes threaten to overwhelm
Two in three women over the age of 20 are either overweight or
obese, researchers have found. And after falling for four decades,
death rates from heart disease appear to be rising among U.S. women
aged 35 to 54.
Black women are especially hard hit by hypertension (high blood
pressure) and heart disease, while Hispanic women have more than
double the rates of diabetes as non-Hispanic white women (12.7
percent compared to 6.5 percent).
To reduce the risk of heart disease, women should keep their
total cholesterol level at 200 milligrams per deciliter (mg/dL) or
less; blood pressure at 120/80 mm Hg; and have a fasting blood
glucose under 100 mg/dL.
Women should maintain a body mass index of less than 25, avoid
smoking, cut down on salt, eat plenty of fruits, vegetables and
whole grains, and do at least 150 minutes of moderate physical
activity a week or 75 minutes of vigorous activity, according to
Studies have shown that only about 4 percent of women aged 50 to
79 do all of these things and are considered at the lowest risk for
heart disease; 72 percent were at "some risk" of heart disease,
while 11 percent were at high risk, defined as a 20 percent or
greater chance of having a heart attack or stroke in the next 10
Other updates in the 2011 guidelines include:
Scientific evidence regarding women and heart disease is still
limited. "The women we see are often sicker, older and have many
more co-morbidities than women who participate in clinical trials,"
Mosca said. For example, women tend to have more side-effects from
statins. "The evidence isn't all that strong for statin use as a
primary prevention in women," she said. "We want future trials to
publish data by gender not just for the benefits but also for the
Dr. Annabelle Volgman, medical director of the Rush Heart Center
for Women in Chicago, said there's still a long way to go in making
sure women understand their heart disease risk.
"Fifty-four percent of women know about the risk, but that means 46 percent of women still don't know it's the No. 1 killer," Volgman said. "And although there's been a decline in death rates from heart disease in women, we are seeing more young women 35 to 54 years old having strokes."
A newly approved drug, Pradaxa (dabigatran) is a good
alternative to Coumadin (warfarin) for treating atrial
"I find women are more reluctant than men to take drugs. So I always say, "It's Prada with a 'xa,'" Volgman said.
Heart Association has more on preventing heart disease in
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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