Caring for Women’s Hearts

Learn which important screenings can help women identify heart attack risk

by Sharon Sadeghinia, Cardiologist

Heart problems may be the leading cause of death among both men and women, but its symptoms, treatment and preventive care can be significantly different for each.

Take heart attacks, for example. In men, common symptoms of heart attack include a sudden crushing sensation in the chest, shortness of breath and pain shooting down the left arm.

However, in women, symptoms may include persistent indigestion, unusual fatigue, nausea, belching and gas pain for a month or even more before the heart attack itself.

The fact that women’s symptoms can be so subtle — and easily mistaken for something as benign as an upset stomach — illustrates why frequent, thorough screening exams for cardiovascular disease are so important for female patients.

High blood pressure and heart attacks

One of the most important screenings is blood pressure. High blood pressure, or hypertension, is a very common condition that increases the risk of heart attack and stroke.

Beginning in your 30s, an annual blood pressure screening (or more often if recommended by your physician) can monitor your risk of hypertension and related health problems, and is the best way to avoid the damage that high blood pressure can cause.

Normal blood pressure is less than 120/80; at a level of 135/85, you have double the risk of developing a heart attack or stroke compared to a woman whose blood pressure is 115/75.

As blood pressure increases, so does the risk. If yours is above normal, your physician can recommend lifestyle changes, dietary adjustments and/or medications to help lower your blood pressure and decrease your risk of heart disease.

HDL and LDL cholesterol levels in women

You’ve probably heard of “good” and “bad” cholesterol. If too much of the “bad” kind, known as LDL, builds up in the walls of the arteries that carry blood to your heart, it can prevent the blood from flowing freely.

This is known as atherosclerosis or hardening of the arteries, and can lead to a heart attack or stroke. Too little of the “good cholesterol, known as HDL, can also increase your risk of heart disease — we believe that HDL helps control LDL levels, so not enough HDL can be a cause for concern.

Ideal LDL levels should be less than 100, while HDL should be above 45. Most physicians recommend annual cholesterol tests for women starting at age 40; if you have a higher than average risk of heart disease, your doctor may recommend testing earlier or more often.

C-reactive protein and heart disease risk

Another risk factor for heart attack or stroke is the amount of protein in your blood, which can indicate the presence of inflammation. Inflamed blood vessels are much more prone to injury and, in turn, to developing scar tissue, which can attract plaque and lead to narrowed or blocked arteries.

The C-reactive protein (CRP) test is a blood test that measures the amount of protein in your blood; a high CRP level may signal a higher risk for heart disease. A CRP test is often performed annually along with cholesterol screening.

Prevention: decreasing risk of heart disease

There are a number of healthy lifestyle and nutrition habits you can integrate into your everyday life to help decrease your risk of heart disease, including eating a low-fat diet rich in antioxidants and Omega-3 fats, exercising for at least 30 minutes a day, managing your stress, and getting plenty of sleep.

If you’re over age 50, talk with your physician about taking a daily baby aspirin (81 mg) to help ward off blood clots. (Some medications, such as NSAIDs, should not be taken with aspirin.) By making smart choices, you can help yourself and your heart.

This Scripps Health and Wellness information was provided by Sharon Sadeghinia, MD, a cardiologist affiliated with Scripps Memorial Hospital La Jolla.