Heart disease often is thought to be a condition more related to men than women, however; just the opposite is true – more women than men die of heart disease each year. Women are six times as likely to die of heart disease as of breast cancer. Heart disease kills more women age 65 years and older than all cancers combined.

A recent 10-year new study (194 – 2004) published in the Canadian Medical Association Journal, showed high death rates and high hospital admissions related to cardiovascular diseases — heart attacks, heart failure and stroke — in women. Of the patients who died of cardiovascular diseases in 1994, 49.3 percent were women. That increased to 50.5 percent 10 years later. This data highlights the need for increased investment in education and research on cardiovascular health and disease in women.

While heart disease is the leading cause of death for women age 65 years and older, it's the third-leading cause of death for women age 25 to 44 years old and the second-leading cause of death for women age 45 to 64 years old. Women under the age of 65 years old who have a family history of heart disease should pay particularly close attention to the heart disease risk factors. Still, all women, of all ages, should take heart disease seriously.

Although the traditional risk factors for coronary artery disease, such as high cholesterol, high blood pressure and obesity, affect women and men, other factors may play a bigger role in the development of heart disease in women. For example:

• Metabolic syndrome — a combination of fat around your abdomen, high blood pressure, high blood sugar and high triglycerides — has a greater impact on women than on men.
• Mental stress and depression affect women's hearts more than men's.
• Smoking is a greater risk factor for heart disease in women than in men.
• Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (small vessel heart disease).

There are several lifestyle changes you can make to reduce your risk of heart disease:

• Exercise 30 to 60 minutes a day most days of the week.
• Maintain a healthy weight.
• Quit or don't start smoking.
• Eat a diet that's low in saturated fat, cholesterol and salt.

In general, women should do moderate exercise, such as walking at a brisk pace for 30 to 60 minutes most days of the week. If you can't get all of your exercise completed in one session, it's fine to break up your physical activity into several 10- to 15-minute sessions. You'll still get the same heart-health benefits.

There are other small changes you can make to increase your physical activity throughout the day. You can take the stairs instead of the elevator, walk or ride your bicycle to do errands or to work, or try some sit-ups or push-ups while watching TV.

What's considered a healthy weight varies from person to person, but having a normal body mass index (BMI) is helpful. The BMI calculation lets you know if you have a healthy or unhealthy percentage of body fat. A BMI of 25 or higher can be associated with an increased risk of heart disease. Losing just 10 to 15 pounds can help by lowering blood pressure and helping to prevent diabetes, both of which increase the risk of heart disease.

It’s also important to take prescribed medications such as blood pressure medications, blood thinners and aspirin appropriately. In women, aspirin therapy seems to reduce the risk of stroke more than in men, while in men it reduces the risk of heart attack more than it reduces stroke. Guidelines recommend women consider taking aspirin. Have a discussion with your doctor about the risks and benefits of taking aspirin based individual stroke and heart attack risk. The higher the risk of heart attack or stroke, the more the risk is reduced by taking aspirin, but you’ll also have a higher risk of bleeding as a side effect of the aspirin therapy.

And women also need to make sure they manage other conditions that are risk factors for heart disease such as high blood pressure, high cholesterol and diabetes. Some women at high risk of heart disease may also benefit from the use of supplements, such as omega-3 fatty acids.

All women face the threat of heart disease. But becoming aware of symptoms and risks unique to women, as well as eating a heart-healthy diet and exercising, can help protect you.

Dr. Omar Wani, interventional cardiologist, is a physician at the Heart & Vascular Center of Northern Arizona. Dr. Wani specializes in all aspects of interventional cardiac and vascular medicine, with a special interest in women’s heart disease. To learn more about treatment options for cardiovascular conditions and disease, visit NAHeartCare.com. To make an appointment with Dr. Wani or one of the other world-class physicians at the Heart & Vascular Center of Northern Arizona, call 877 928-WELL.