Heart Disease:The Greatest Threat of All

Think of a heart attack victim and you'll probably picture a middle-aged man, perhaps a little paunchy, most likely a workaholic executive type. It's a stereotype that has been reinforced by the media and by the medical profession itself, which in the past has focused much of its research into heart disease on this type of patient.

Not Just a Man's Disease

The facts, however, tell quite a different story. Heart disease is more than just a man's disease -- much more. Better than 1 in 5 women have some form of heart or blood disease. By the time a woman reaches 65, she has a 1 in 3 chance of developing cardiovascular disease. And a number of studies show that African-American women are at even greater risk than these averages.

Heart disease, in its various forms, is the leading killer of American women. The following statistics paint a graphic picture:

The reason that so much more attention has been focused on men is that they are much more likely to be stricken with heart disease in their prime middle years, whereas women tend to get it 10 to 20 years later. For most women, it is only after menopause that heart disease becomes a problem. But a woman of 60 is about as likely to get heart disease as a man of 50, and by the time they are in their 70s, men and women get heart disease at equal rates. In the past two decades, death rates from cardiovascular disease have declined in both men and women, but have gone down more slowly in women.

Cardiovascular Disease: The Fate of Every Third Woman

The facts, however, tell quite a different story. Heart disease is more than just a man's disease -- much more. Better than 1 in 5 women have some form of heart or blood disease. By the time a woman reaches 65, she has a 1 in 3 chance of developing cardiovascular disease. And a number of studies show that African-American women are at even greater risk than these averages.

Heart disease, in its various forms, is the leading killer of American women. The following statistics paint a graphic picture:

• One-third of all deaths of American women each year are attributable to heart disease. Heart disease kills more women each year than all types of cancer, accidents, and diabetes combined.

• All forms of cardiovascular disease kill more than 500,000 American women a year (compared to about 450,000 men). Stroke alone kills more than 97,000 women annually.

• Myocardial infarction, commonly known as a heart attack, kills 244,000 women a year.

• Forty percent of women with heart disease will eventually die of it.

• About 6.3 million American women alive today have a history of heart attack, angina (chest pain), or both.

The reason that so much more attention has been focused on men is that they are much more likely to be stricken with heart disease in their prime middle years, whereas women tend to get it 10 to 20 years later. For most women, it is only after menopause that heart disease becomes a problem. But a woman of 60 is about as likely to get heart disease as a man of 50, and by the time they are in their 70s, men and women get heart disease at equal rates. In the past two decades, death rates from cardiovascular disease have declined in both men and women, but have gone down more slowly in women.

The significance of these facts is clear when you consider the aging of the American population. Currently, 38 percent of American women are 45 years of age or older and nearly 50 million have reached or passed 50 years of age. By 2015, that percentage will rise to 45 percent. This means that heart disease in women will be an even bigger problem in the future than it is now.

In the past, care of women with heart disease was based primarily on what was known about men. Given the many factors unique to a woman's health, it became apparent that this approach was not satisfactory. Prevention, diagnosis, and treatment cannot adequately take account of these factors until they have been systematically studied and evaluated.

Women have paid a heavy price for medicine's excessive focus on male heart patients, suffering delayed diagnosis, inadequate treatment, and a toll that could be counted in disabilities and death. One study found that an increased death rate in women following heart attacks was associated with less use of certain treatments, such as clot-busting drugs, compared to men.

Finally, however, this situation is changing. Greater attention to women's health in general and a growing awareness of the risks of heart disease in women are replacing the disregard of the past. An increasing number of scientific studies are focusing on how heart disease affects women. Gradually, doctors are becoming better informed about the dangers to women from heart disease, so that they are less likely to attribute chest pain to anxiety or other non-heart-related problems. And women themselves are learning that their own attention to their health must not be limited to an annual visit to the gynecologist.

So why is this important? If nothing could be done about heart disease, all of this attention might be academic. However, heart disease is both preventable and treatable; and as doctors learn more about what causes the problem, it is becoming increasingly apparent that there is much that you can do to prevent it from ever occurring. Diet and lifestyle changes can be very effective preventive efforts for some forms of heart disease. To work best, these efforts should begin early in life, long before you perceive yourself to be at risk. And if heart disease does strike, modern science and technology have an ever-growing arsenal of weapons available to successfully fight it and restore its survivors to healthy and productive lives.

Statistics reflect an encouraging trend. Better understanding of preventive measures and increasing sophistication in diagnosis and treatment have resulted in decreasing rates of heart disease in both men and women. For example, from 1987 to 1997, the death rate from coronary heart disease in women declined 23.5 percent, while the death rate from all forms of cardiovascular disease among women went down 17.5 percent.