Generally, heart disease is thought of as more of a problem for men than women, although it’s the number one cause of death for both. Most women in middle age know someone who has had breast cancer, but few know other women with heart disease. The reason is that for most women heart disease tends to show up later in life. The average age for a woman with a heart attack is 70. 

Chest discomfort 

The common presenting complaint for both men and women with heart disease is the same: some type of chest discomfort. The discomfort can be constant for a period of time or may come and go. 

In women, chest pain may not be the most severe symptom. Some women describe it as tightness or pressure. Women are also more likely to complain of other symptoms, such as jaw, neck, or shoulder pain; sweating; fatigue; or indigestion. Women are also more likely to experience symptoms when resting or even sleeping. 

Risk factors 

The risk factors for heart disease in women are the same as the risk factors in men. Diabetes is a strong risk factor, as is smoking. Lack of exercise, poor diet, or being overweight are all risk factors. 

A family history of heart disease is also an important risk factor. Heart disease is more common in women after menopause than during their reproductive years. All women should get their lipids tested, because low HDL and high triglycerides appear to be the only factors that increase the risk of death from heart disease in women over age 65. 

Reducing the risk 

A healthy lifestyle can reduce the risk of heart disease. It’s important to: 

• Quit smoking, which reduces the risk of both heart disease and lung cancer. 
• Maintain a healthy weight through regular exercise and a diet that is low in saturated fat and salt. 
• Work with health care providers to manage conditions such as diabetes, high cholesterol, or high blood pressure. 

Other resources 

The American Heart Association has a website dedicated to helping women reduce their risk of heart attacks and strokes at www.goredforwomen.org.

For a common-sense approach to heart healthy eating, go to the NIH National Heart, Lung, and Blood Institute’s DASH Eating Plan page at www.nhlbi.nih.gov/health.

Charles Rollinger, MD, Vice President of Medical Management and Quality, US Family Health Plan