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Women’s Heart Risks Form Focus of “Wear Red
2/2/2007
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Campaign is designed to draw attention to a widely overlooked threat to women’s health

by Craig Weatherby


Next Friday, February 1st, is National “Wear Red” Day: a campaign by the National Heart, Lung, and Blood Institute and the American Heart Association.


Women’s high risk of heart disease is often overlooked, in part because of the more high-profile and potentially disfiguring threat of breast cancer, which kills far fewer females in the US.


Unfortunately, the ways in which cardiovascular disease (CVD) manifests in women make it harder to detect before it’s too late to treat. For more on this, see “Women’s heart disease differs from men’s”, below.


Fortunately, recent research reinforces the CVD-prevention power of fish oil for women. For more on these encouraging findings, see “Finns Find Fish Slows Heart Disease in Women.


Campaign organizers hope that Americans will wear red on Friday, February 1st, to help raise awareness of women's under-recognized risk of heart disease.


Women and heart disease, by the numbers

These surprising statistics come from the American Heart Association:

  • Only 13 percent of women view heart disease as a health threat, even though it’s the No. 1 killer of women over age 25.
  • One in 2.6 female deaths are from cardiovascular disease (CVD), compared with one in 30 from breast cancer.
  • CVD claims more lives than the next four most common causes of death combined: 480,000 women a year or about one per minute.
  • One in three adult women in the United States suffers from a form of CVD.
  • 64 percent of women who died suddenly of coronary heart disease had no previous symptoms.
  • Heart disease rates in post-menopausal women are two to three times higher than in pre-menopausal women of the same age.
  • Stroke is the No. 3 cause of death for American women, and is a leading cause of serious, long-term disability.
  • Stroke kills more women than men. In 2003, females represented 61 percent of stroke deaths.

These sources offer information about the Wear Red campaign, about heart disease in women, and ways to reduce the risks:

Women’s heart disease differs from men’s and defies detection

Even though the reduction of blood flow that can lead to heart attacks is often considered a man's disease, it takes the lives of more women than men each year.


New research findings show that cardiovascular disease in women differs from men’s in important ways. As a consequence, women's heart disease often evades traditional diagnostic techniques and continues to cause symptoms until it progresses to a dangerous degree.


These findings come from The Women's Ischemia Syndrome Evaluation (WISE) Study, a large, long-term investigation  (Ischemia” means “constricted blood supply”: a condition characteristic of cardiovascular disease).


When people experience chest pain, doctors usually look for signs of fatty, calcified arterial plaque in arteries. This phenomenon, called atherosclerosis, characterizes heart disease in men.


But in many women, problems in two other areas—the lining of coronary arteries and tiny blood vessels within the heart itself—combine to rob the heart’s muscles of oxygen.


The WISE study’s findings provide the first detailed picture of the circulatory problems specific to heart disease in women.  Although the "diffuse atherosclerosis" that many women experience is not apparent on the coronary angiograms normally used to look for arterial clogs, it results in reduced blood flow to the heart’s own tissues.


Absent any evidence of a blocked artery, a woman's symptoms are likely to be dismissed as signs of something unknown and far less dangerous than heart disease.


Making diagnosis harder, women's symptoms frequently differ from men's. Women may report fatigue, sleep disturbances and shortness of breath, all of which may be dismissed as irrelevant to heart disease or mistakenly attributed to benign conditions.


Other CVD risk factors in women include anemia and inflammation in the arteries. Accordingly, the most promising early-detection test options include testing for blood levels of C-reactive protein—a key inflammatory chemical—and monitoring of hemoglobin levels (blood iron-carrying capacity).


In addition, physicians may look for narrowing of the retinal artery and calcification in coronary arteries, conduct stress tests that can reveal the blood flow problems characteristic of women’s heart disease, and administer questionnaires regarding daily diet and activities. (Sedentary women suffer a significantly higher risk of CVD.)


Risks are also increased among women who are diabetic, obese, or have three or more of the cluster of five predisposing physical characteristics and biochemical risk factors called “metabolic syndrome” (e.g., obesity, unhealthful blood fat or cholesterol profile, high blood pressure, and high blood sugar).



Sources

  • National Heart, Lung, and Blood Institute at www.hearttruth.gov, 301-592-8573, TTY: 240-629-3255
  • National Heart, Lung, and Blood Institute at www.WomensHealth.gov, 1-800-994-WOMAN, TDD: 1-888-220-5446
  • American Heart Association. Quick Facts about Heart Disease & Stroke. Accessed online January 30, 2007 at http://www.goredforwomen.org/love_your_heart/quick_facts.html
  • National Heart, Lung, and Blood Institute. Women's Health Initiative. Questions and answers about the estrogen-alone study. Accessed online February 18, 2006 at http://www.nhlbi.nih.gov/whi/e-a_faq.htm#q1.
  • Bairey Merz CN, Shaw LJ, Reis SE, Bittner V, Kelsey SF, Olson M, Johnson BD, Pepine CJ, Mankad S, Sharaf BL, Rogers WJ, Pohost GM, Lerman A, Quyyumi AA, Sopko G; WISE Investigators. Insights from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part II: gender differences in presentation, diagnosis, and outcome with regard to gender-based pathophysiology of atherosclerosis and macrovascular and microvascular coronary disease. J Am Coll Cardiol. 2006 Feb 7;47(3 Suppl):S21-9.
  • Gierach GL, Johnson BD, Bairey Merz CN, Kelsey SF, Bittner V, Olson MB, Shaw LJ, Mankad S, Pepine CJ, Reis SE, Rogers WJ, Sharaf BL, Sopko G; WISE Study Group. Hypertension, menopause, and coronary artery disease risk in the Women's Ischemia Syndrome Evaluation (WISE) Study. J Am Coll Cardiol. 2006 Feb 7;47(3 Suppl):S50-8.
  • Handberg E, Johnson BD, Arant CB, Wessel TR, Kerensky RA, von Mering G, Olson MB, Reis SE, Shaw L, Bairey Merz CN, Sharaf BL, Sopko G, Pepine CJ. Impaired coronary vascular reactivity and functional capacity in women: results from the NHLBI Women's Ischemia Syndrome Evaluation (WISE) Study. J Am Coll Cardiol. 2006 Feb 7;47(3 Suppl):S44-9.
  • Shaw LJ, Bairey Merz CN, Pepine CJ, Reis SE, Bittner V, Kelsey SF, Olson M, Johnson BD, Mankad S, Sharaf BL, Rogers WJ, Wessel TR, Arant CB, Pohost GM, Lerman A, Quyyumi AA, Sopko G; WISE Investigators. Insights from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part I: gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies. J Am Coll Cardiol. 2006 Feb 7;47(3 Suppl):S4-S20.
  • Shaw LJ, Olson MB, Kip K, Kelsey SF, Johnson BD, Mark DB, Reis SE, Mankad S, Rogers WJ, Pohost GM, Arant CB, Wessel TR, Chaitman BR, Sopko G, Handberg E, Pepine CJ, Bairey Merz CN. The value of estimated functional capacity in estimating outcome: results from the NHBLI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study. J Am Coll Cardiol. 2006 Feb 7;47(3 Suppl):S36-43.
  • Pepine CJ, Kerensky RA, Lambert CR, Smith KM, von Mering GO, Sopko G, Bairey Merz CN.  Some thoughts on the vasculopathy of women with ischemic heart disease. J Am Coll Cardiol. 2006 Feb 7;47(3 Suppl):S30-5.
  • Cote S, Dodin S, Blanchet C, Mulvad G, Pedersen HS, Blanchet C, Holub BJ, Dewailly E. Very high concentrations of n-3 fatty acids in peri- and postmenopausal Inuit women from Greenland. Int J Circumpolar Health. 2004;63 Suppl 2:298-301.
  • Saldeen P, Saldeen T. Women and omega-3 Fatty acids. Obstet Gynecol Surv. 2004 Oct;59(10):722-30; quiz 745-6. Review.
  • Hsia J et al. Conjugated Equine Estrogens and Coronary Heart Disease. Arch Intern Med. 2006;166:357-365.
  • Erkkila AT, Lichtenstein AH, Mozaffarian D, Herrington DM. Fish intake is associated with a reduced progression of coronary artery atherosclerosis in postmenopausal women with coronary artery disease. Am J Clin Nutr. 2004 Sep;80(3):626-32.
  • Hu FB, Bronner L, Willett WC, Stampfer MJ, Rexrode KM, Albert CM, Hunter D, Manson JE. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA. 2002 Apr 10;287(14):1815-21.

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