The document discusses that heart disease is the leading cause of death for both men and women, contrary to the myth that it mainly affects older men. While risk factors are the same, women experience heart disease differently than men. Women are more likely to have "normal" test results yet still suffer a heart attack. The symptoms of a heart attack in women also differ from the stereotypical symptoms experienced by men. The document emphasizes the importance for physicians to be aware of these gender differences in heart disease.

1. NOT A MAN’S DISEASE
A brief primer on women’s heart
health for physician assistants

2. 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

3. Research shows disparities
in diagnosis and treatment
The vast majority of cardiovascular research has been
performed on men, despite clear differences in how the
disease affects men and women
Men tend to be treated earlier, and more aggressively,
for heart disease
Many physicians are not aware of the differences in
heart disease between men and women; even specialists
like gynocologists tend not to explore heart disease risk
factors

4. The Estrogen Connection
Risk factors for heart disease ARE the same for men
and women: smoking, alcohol, a family history, poor
diet, sedentary lifestyle and the presence of diabetes
dramatically increase risk and reduce longevity
However, women who have experienced menopause
face an addition risk due to the loss of estrogen, which
seems to provide some protection against heart disease

5. What does a heart attack
look like?
What does a person look like when he or she is having
a heat attack?
Consider the image you have in your mind and name
2-3 symptoms

6. The“Hollywood Heart
Attack” Myth
In the previous activity, did you picture a person
dramatically clutching his chest, perhaps staggering
around?
Some men feel sudden, strong stabbing pains in the
chest. But for most women, typical symptoms include:
unexplained fatigue, nausea, shortness of breath, pain
in the arms, back and jaw, and severe headache.
Nearly 80 percent of women say they would “wait and
see” or call a friend if they suspect a heart problem.

7. An unexpected
phenomenon
Women are much more likely than men to have
“normal” test results or screenings and still have a heart
attack
Women tend to have less obstructive heart disease,
where the arteries clog over time. Instead, they are
vulnerable to rapid development of plaque on vessel
walls. This means they might “pass” a stress or
cholesterol test, but deteriorate in between screenings.

8. Wrap-up and reflection
Heart disease is called “the silent killer” because it
shows no symptoms while it develops--not even in the
days or hours before a heart attack. This highly
preventable disease claims the lives of 1 in 3 Americans,
both men and women. However, it’s important for
clinical staff to keep in mind that women do experience
the disease differently.
What can you do to promote women’s heart health
awareness in your practice?

9. Learn more about women
and heart disease
Minutes are muscle--educate patients about symptoms
and the importance of calling 911. Access materials
from the “Make the call, Don’t Miss a Beat” campaign
at womenshealth.gov/heartattack
Download a free Healthy Heart Handbook for Women
at nhlbi.nih.gov/educational/hearttruth/materials
Check out the American Heart Association’s easy-to-
use risk calculators at heart.org