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The Number One Killer of Women
The Number One Killer of Women
by Dr. Jeffrey Carlson
Heart attack and stroke kill 10 times as many women each year as Breast Cancer.
439,000 women died of heart attack or stroke in 2000, the most frequent causes of death in women. One tenth as many, 42,000, died of breast cancer. Nevertheless, Heart Disease is not considered a woman's disease. Each year 1.1 million people have a heart attack, of which 370,000 die, 250,000 in the first hour. By age 60, every 17th woman develops Coronary Heart Disease. By age 70, every 8th woman will have had a heart attack or heart pain.
The younger the woman, the more likely the first symptom will be sudden death. Once an older woman gets heart disease, they will be more affected with more debilitating symptoms and more early death than a man.
I began my Cardiology practice in Hayward and Fremont 24 years ago. We were just beginning to understand how to help people with heart attacks and other forms of heart disease. All my patients were men. Over the last 10 years, half my patients have become women. Although women are more severely affected and older, they are often more treatable.
Men begin developing their heart disease when they are 9 years old. It is a slowly progressive disease that finally culminates in a heart attack or stroke in the 50s or 60s. Women almost regardless of their ultimate risk have absolutely normal arteries until menopause. Their disease begins then and progresses over a 10-15 year period to a more severe disease than their brother gradually developed over a 50 year period. This rapid progression does not give a woman the chance to develop the protective mechanisms men often develop over a much longer time period. This rapid progression makes them more susceptible to dying suddenly from a relatively minor event.
Women with Coronary Heart Disease although at higher risk may also have greater benefit from medical care. The rapid accumulation of cholesterol after menopause may also make the cholesterol buildup more easily treatable. The cholesterol plaques in women tend to be foamy and softer than in men. This softness lends itself to being able to be removed using aggressive medical therapies such as cholesterol lowering drugs, good BP control, and good blood sugar control in those with diabetes.
My advice to women with a family history of heart disease is for them to find out what the risk factors are that cause the problem and to work with their physicians to correct those risks they may have inherited. Also, if your Mother had her heart attack at 60 don't wait until you are 59 to begin worrying. Moreover, your mindset for improving your risks should be about YOU, not about groups. Studies will often say that one treatment or another will reduce the potential risk of a heart attack by 30%. What about the other 70%? Be aggressive with your own health. Be sure you are reducing your personal risk as much as possible.
We have enough data to know that having heart disease is a choice. If you let yourself go, put on weight, eat the wrong food, continue to smoke, avoid exercise, you are choosing to have a heart attack. The reverse is also true, and we now know what the ultimate goals for treating these risks are. Heart Disease is not only preventable it is reversible.
Dr. Jeffrey Carlson is board certified in both Internal Medicine and Cardiology. Dr. Carlson has an office in Hayward and Fremont and he has clinical privileges at St. Rose Hospital and Washington Hospital.
We welcome your questions!
Physicians on staff at St. Rose Hospital are interested in responding to your questions about health care and related topics such as health education and prevention.
Please send any questions to: TheDoctor@strosehospital.org