Heart disease affects women differently

HARTSVILLE – In conjunction with National Wear Red Day, Cardiologist Dr. William B. Epps of Hartsville discussed women and heart disease during the Carolina Pines Regional Medical Center’s monthly Lunch and Learn program on Wednesday.

The leading cause of death for women is heart disease, which kills 250,000 each year in the United States.

“Women have a considerably higher risk of dying from a heart attack,” Epps said.

Men’s mortality rate from heart disease has been falling, but that’s not the case for women. The under-diagnosis and under-treatment of heart disease in women contributes to the high mortality rate, Epps said.

Women fare 30 percent worse than men during heart surgery because they have smaller arteries and are often older when they develop the disease. Women on average develop heart disease 10 years later than men.

“If you get heart disease, it develops in one of three ways. One, you have a heart attack. Two, you die suddenly, or, three, you start to develop chest pain,” Epps said.

Chest pain is where there is a big gender difference.

Women are four times more likely to be told that their perceived symptoms are psychiatric due to stress or nerves.

“It’s up to you to be proactive,” Epps said. He encouraged women to ask questions not just turn around and leave their doctor’s office.

Other symptoms signaling the onset of heart disease for women are shortness of breath, feeling tired for no reason or pain in the back, jaw, shoulder or right side of the body.

Additionally, women can have no symptoms and still have a bad heart.

Doctors often fail to recognize heart disease in women until the problem is much worse and the patients are much older.

Once a woman is properly diagnosed, the differences continue. Women tend to do worse with angioplasty than men because of their smaller arteries. Women are more likely to have residual pain and to need medication following heart surgery too.

“Most other medications are all underutilized in women,” Epps said. “Women in general have less incidence of being put on the medications that have been proven helpful.”

Aspirin can help both men and women after a heart attack, but for prevention it only helps women age 65 and older though it can decrease a woman’s stroke risk for those age 45 and older.

Blood pressure, smoking and physical activity are three risk factors where gender plays a significant role and where women have some control.

Blood pressure reflects how much force the heart puts on the arteries, so keeping your numbers close to 120/80 is important. Anything over 130 increases your risk for heart attack and stroke.

Smoking is particularly dangerous for women because of the common combination with birth control pills, which can result in blood clots.

“The more you smoke the higher your risk,” Epps said.

Smoking one pack of cigarettes a day increases your risk of heart disease six times.

Physical activity is more important to women as a risk factor than for men. Lack of physical activity is more dangerous because of the company it keeps: weight gain, higher blood pressure and higher cholesterol levels.

The next Lunch and Learn program about colonoscopies will be at noon March 3 at the hospital’s education room. April’s topic will be joint replacement.