NOT A MAN’S DISEASE A brief primer on women’s heart health for physician assistants
Heart disease is the #1 killer for both men and women The idea that mainly men, or much older women, have heart attacks is a long-standing myth--one that even some primary care physicians believe The fact is, since the 1980s, more women than men have died from heart disease Women are more likely than men to die during the ﬁrst year after a heart attack or suﬀer long-term debilitation Most women who have heart attacks are under age 60
Research shows disparitiesin diagnosis and treatmentThe vast majority of cardiovascular research has beenperformed on men, despite clear diﬀerences in how thedisease aﬀects men and womenMen tend to be treated earlier, and more aggressively,for heart diseaseMany physicians are not aware of the diﬀerences inheart disease between men and women; even specialistslike gynocologists tend not to explore heart disease riskfactors
The Estrogen ConnectionRisk factors for heart disease ARE the same for menand women: smoking, alcohol, a family history, poordiet, sedentary lifestyle and the presence of diabetesdramatically increase risk and reduce longevityHowever, women who have experienced menopauseface an addition risk due to the loss of estrogen, whichseems to provide some protection against heart disease
What does a heart attack look like?What does a person look like when he or she is havinga heat attack?Consider the image you have in your mind and name2-3 symptoms
The“Hollywood Heart Attack” MythIn the previous activity, did you picture a persondramatically clutching his chest, perhaps staggeringaround?Some men feel sudden, strong stabbing pains in thechest. But for most women, typical symptoms include:unexplained fatigue, nausea, shortness of breath, painin the arms, back and jaw, and severe headache.Nearly 80 percent of women say they would “wait andsee” or call a friend if they suspect a heart problem.
An unexpected phenomenonWomen are much more likely than men to have“normal” test results or screenings and still have a heartattackWomen tend to have less obstructive heart disease,where the arteries clog over time. Instead, they arevulnerable to rapid development of plaque on vesselwalls. This means they might “pass” a stress orcholesterol test, but deteriorate in between screenings.
Wrap-up and reﬂectionHeart disease is called “the silent killer” because itshows no symptoms while it develops--not even in thedays or hours before a heart attack. This highlypreventable disease claims the lives of 1 in 3 Americans,both men and women. However, it’s important forclinical staﬀ to keep in mind that women do experiencethe disease diﬀerently.What can you do to promote women’s heart healthawareness in your practice?
Learn more about women and heart diseaseMinutes are muscle--educate patients about symptomsand the importance of calling 911. Access materialsfrom the “Make the call, Don’t Miss a Beat” campaignat womenshealth.gov/heartattackDownload a free Healthy Heart Handbook for Womenat nhlbi.nih.gov/educational/hearttruth/materialsCheck out the American Heart Association’s easy-to-use risk calculators at heart.org