A Woman's Risk for Heart Attack or Stroke

A Woman's Risk for Heart Attack or Stroke

Heart disease is the leading cause of death among women, but it's also one of the most preventable. Here's how to know if you're in the danger zone.

Each year, more than one million Americans experience a heart attack. According to research published in the American Heart Association's online journal Circulation, nearly half of these heart attacks are fatal. Stroke is the leading cause of disability and the third leading cause of death for women and men. More women have strokes than men, and women are more likely to die as a result of a stroke. Many people believe that heart attacks are a problem for only older men, yet heart disease is the No. 1 killer of women in the United States.

The Difference Between a Heart Attack and a Stroke
In most instances, a heart attack is caused by a small blood clot lodged within a blood vessel leading to either the heart or the brain. If blood clots form in the blood vessels serving the heart, they cause a heart attack. Blood clots that develop or travel to the blood vessels in the brain cause a stroke.

What Makes Women Susceptible to Heart Disease?
The traditional risk factors—high cholesterol, high blood pressure, and obesity—affect both women and men, but other factors may be more important in the development of heart disease in women:

  • Metabolic syndrome (a combination of fat around your abdomen, high blood pressure, high blood sugar, and high triglycerides)
  • Mental stress and depression
  • Smoking
  • Low levels of estrogen after menopause
  • Family history of heart disease

Make Lifestyle Changes to Reduce Risk
Marianne J. Legato, MD, FACP, the founder and director of The Partnership for Gender-Specific Medicine at Columbia University, says the No. 1 thing women can do to prevent heart disease is reduce stress in their lives. "Try to be less stressed," she advises. "Deal with your life head-on. If you have a nagging problem you can't solve, it's very important to talk to somebody. Not everything needs a shrink. Talking to a true friend may be the best therapy there is."

How can you tell if stress is becoming a factor? "Look at what you are doing in excess," Legato advises. "Are you overeating or not eating? Shopping? Drinking? Gambling? Any of these are indicators." She also cautions women to take care of themselves and to know their risk factors. "Women tend to neglect their own health and concentrate on husbands and kids," she says. "They tend to avoid knowing anything bad because they are apprehensive, but they need to trust themselves and take action when needed."

Legato notes that exercise is essential to reducing stress, even if it's just walking. "Walk everywhere, as fast as you can," she says. Increase physical activity, such as taking the stairs instead of the elevator, walking or riding your bicycle to do errands, parking your car a good distance from the mall, or doing some sit-ups or push-ups while watching TV.

Other lifestyle changes you can make to reduce your risk of heart disease include not smoking, maintaining a healthy weight, and eating a heart-healthy diet.

"Keep a detailed food diary for two weeks," Legato recommends. Write down everything you eat, and then see a skilled nutritionist who can help you include more of the following:

  • Fruits and vegetables
  • 100% Whole grains
  • Fat-free or low-fat milk and milk products
  • Lean protein, poultry, fish, beans, eggs, and nuts
  • Foods that are low in saturated fats, trans fats, cholesterol, salt, sodium, and added sugars

If you have a medical condition that is a contributing factor for heart disease, such as high blood pressure, high cholesterol, or diabetes, make sure to follow your doctor's advice, take your prescription medicines appropriately, and keep your blood pressure and blood sugar under control. Some women at high risk of heart disease may also benefit from the use of supplements, such as omega-3 fatty acids.

Legato cautions women on taking a daily aspirin as a preventive measure. "There are new guidelines on aspirin," she says. "It doesn't prevent heart attacks in women. I no longer allow my women patients to take it due to catastrophic bleeds."

Medically reviewed in February 2019.

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