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
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,
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
"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. …