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Cynthia Morse never imagined it was possible to have a heart attack in her early 30s. But it happened: In 1999, this mother of two suffered sudden cardiac arrest while shopping at Home Depot. "I keeled over in the carpet aisle," recalls Morse, now 37. "I never thought I'd have something life-threatening happen at such a young age." Fortunately, a nurse happened to be in the store; she administered CPR and got Morse's heart beating again.
Although Morse was in a coma for a couple of days, she recovered fairly quickly; she was in good health overall and didn't have a family history of heart disease. "I suspect that because I'm an active, healthy person, I fared better than I might have otherwise," says Morse. Nevertheless, the experience was a wake-up call, alerting her to the reality that heart problems can strike younger women, too. That's why Morse, who now wears a pacemaker, takes steps to prevent heart disease — and so should you!
A Women's Disease, Too
According to the latest statistics, each year 499,000 women die from heart disease, making it the leading cause of death for this group. Yet, a recent survey by the American Heart Association (AHA) revealed that only 34% of women identify heart disease as the primary cause of death for women, and a mere 8% view heart disease as their greatest personal health threat. Why are women so ill-informed? "Statistically, women typically develop heart disease 10 years later than men, but it can happen to younger women," says Rose Marie Robertson, M.D., past president of the AHA and a professor of medicine at Vanderbilt University Medical Center in Nashville. "Unfortunately, both physicians and women have the bias that young women can't have heart disease." In fact, even as the overall cardiac mortality rate has fallen over the past 20 years, it has risen for women. "We haven't focused enough attention on the fact that heart disease starts young. It's very much like osteoporosis: You have to prevent it before it's a problem. You don't build bone after 50 and you don't begin to clear out your arteries either," says Dr. Robertson.
Women and Men Are Different
Although the same risk factors that apply to men — high blood pressure, smoking, being overweight or sedentary, and so on — also apply to women, some risk factors, such as diabetes, play a greater role in women. "Diabetes leads to a two- to threefold increase in heart disease among men but a three- to sevenfold increase in women," says Lori Mosca, M.D., director of preventive cardiology at New York–Presbyterian Hospital. What's more, high triglycerides (blood fats) and low HDL (the "good" cholesterol) are stronger predictors of cardiovascular disease in women than in men. Hormonal issues, such as premature or surgical menopause without hormone-replacement therapy or using oral contraceptives if you're over 35 and are a smoker, can also increase a woman's risk.
Symptoms of heart attack or angina can also be different in women than in men, which is one of the reasons why the disease often goes undiagnosed. While chest pain is the most common symptom of heart trouble in both sexes, women are more likely to suffer from shortness of breath, nausea, fatigue or jaw pain, says Dr. Mosca. And since a heart attack can manifest itself as more of an uncomfortable tightness or heaviness than a sharp pain, the experience may pale next to the agony of childbirth and thus go unchecked, notes Robertson. That's why it's essential that women heed symptoms and seek treatment, especially if pain or tightness in the chest lasts longer than five minutes. "Forty percent of women who have their first heart attack die of it," Mosca says. "There's no second chance for them."
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