Getting the Gender Care Straight A Woman's Risk for Heart Disease Is Greater Than Most People Realize, but the Good News Is, Prevention Is Possible

Article excerpt

The leading cause of death in women, cardiovascular disease, is

often misdiagnosed by physicians who assume women don't have

heart attacks until after menopause.

"When you look at figures at misdiagnosis of heart attack, the

figures are swayed toward women," said Jacksonville cardiologist

Kay Gilmour. "It's not thought to be a woman's disease,

especially if you are premenopausal. The symptoms are not

different. It's simply a matter of the level of suspicion of the

medical observer."

Women are guilty of making the same assumption.

A national survey by Prevention magazine found that a third of

the women knew their risk of dying from a heart attack is

greater than their risk of dying from breast cancer. And 38

percent said they had experienced the symptoms of a heart attack

but had done nothing about it.

"Women pay attention to what kills them at an unexpected age.

Obviously the mortality for breast cancer in young women is a

startling thing," Gilmour said. "To die in your 60s and 70s is

more natural. That's when women catch up to men in mortality

from heart disease. And it is quite preventable."

There is increasing evidence that lowering low-density

lipoprotein or LDL, the bad cholesterol, is a leading indicator

of future heart disease.

Cholesterol can be controlled with low-fat, low-cholesterol

diet and medication.

The Heart and Estrogen/Progestin Replacement Study, an ongoing

study at 18 medical centers involving 2,763 post-menopausal

women with heart disease, has found that fewer than half of the

participants were taking a cholesterol-lowering medication.

Even among those who were, most were probably not receiving an

adequate dose, since the study found that 63 percent of the

participants failed to meet the recommended guidelines for LDL

cholesterol in 1988 and 91 percent did not meet the

recommendations in 1993.

"The drugs are extremely effective in lowering LDL

cholesterol," Gilmour said. "If a women has demonstrated heart

disease, she should be asking her physician, `Why am I not on a

cholesterol-lowering medication?' "

In menopausal women, hormone replacement therapy is critical,

Gilmour said.

Estrogen in women provides a natural protection against heart

disease. As a woman's level of estrogen drops during menopause,

so does her level of protection. Interestingly, estrogen has

been tried in men at risk for heart attack, and it doesn't work.

"Hormones are the absolute major thing," Gilmour said. "It can

reduce the rate of heart attack in women by at least 25 percent

and has been estimated to go as high as 60 percent. It's a

tremendous `Wow!.'

"It is never too late to start. A woman who went through

menopause at 40 or 45 and is now 65 should go to her

gynecologist and say, `Why am I not on hormones?' "

And, when you consider that hormone therapy can prevent

osteoporosis, which is a debilitating and often-fatal disease,

there's no question that women should be taking hormones, she


Women also can take an aspirin a day, which as a blood-thinner

has been shown to prevent heart attacks and strokes in men,

Gilmour said. …


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