Nancy Kearson knew she had high blood pressure, but she wasn't aware of any other health problems until a friend urged her to see a physician four years ago. That exam may have saved her life.
Kearson, who at the time was 53 years old and working for a demanding CPA firm, discovered she was at high risk for a heart attack. Her doctor prescribed cholesterol-lowering medication and baby aspirin daily, and suggested changes to Kearson's diet.
"I was surprised that the risks were as great as they were," she said. "I thought I had good health and would always have it."
Heart disease, often perceived as a men's health issue, affects more than 6 million women in the United States. According to the American Heart Association, heart disease claims more lives among women than cancer, killing one woman every minute. Yet only 13 percent of women consider heart disease their greatest health risk. In an effort to encourage women and men to learn more about heart disease prevention, February was designated as American Heart Month under President Bill Clinton, who himself recently underwent a bypass operation.
"Heart disease is the leading killer of women. [Yet] it is predictable and preventable," said Dr. C. Noel Bairey Merz, medical director of the Women's Health Program at Cedars-Sinai Medical Center. In the case of breast cancer, she said, "We empowered women to pay attention -- to go in and get screening and to demand that they be treated and taken seriously. Now we hope to do the same with heart disease."
Becoming familiar with risk factors and controlling lifestyle choices are the first steps in combating heart disease. Risk factors include cigarette smoking, high blood cholesterol or blood pressure, diabetes, physical inactivity and a family history of heart disease. Research suggests that women can lower their heart disease risk by as much as 82 percent through lifestyle changes (see sidebar).
Screening is equally important.
"Just as they do for a mammogram, women should make an appointment to have a heart-risk assessment each year," Bairey Merz said.
The assessment looks at weight, blood pressure, overall cholesterol level, the level of HDL (good) cholesterol and other factors to determine risk levels. After receiving results, women need to follow with action, Bairey Merz said.
Kearson now sees her cardiologist, Bairey Merz, regularly to have blood work and prevention consultations. She also changed her diet, left her high-stress job to open her own practice and takes morning walks every day.
"I realized my [previous] lifestyle came with a price," she said.
Earlier this month, the American Heart Association announced new guidelines for preventing heart disease and strokes in women, which highlights the need to adopt healthy lifestyle habits throughout life, rather than waiting for a problem to occur.
"The concept of cardiovascular disease as a 'have or have not' condition has been replaced with the idea that [it] develops over time and every woman is somewhere on the continuum," said Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital/Columbia University Medical Center and chair of the group that developed the guidelines.
The guidelines also address treatment, recommending that its aggressiveness be linked to whether a woman has low, intermediate or high risk of having a heart attack in the next 10 years. For high-risk women, aspirin and drug therapy are recommended. Quitting smoking, getting 30 minutes of daily vigorous exercise, eating a heart-healthy diet and maintaining a healthy weight are lifestyle changes recommend for all women.
Bairey Merz said that women must be assertive to get proper care. Women suffering from heart disease are twice as likely to die from it as men, but are less likely to be evaluated for cardiac symptoms -- such as heart palpitations, chest pains and shortness of breath -- and may receive less aggressive treatment once diagnosed.
There are now several national efforts designed to increase attention to women's heart health. They include the American Heart Association's Go Red for Women campaign; the National Heart, Lung, and Blood Institute's The Heart Truth program; and Sister to Sister: Everyone Has a Heart Foundation's National Women's Heart Day.
Bairey Merz hopes that these efforts will result in increased vigilance -- and decreased deaths.
"Society in general has not valued women's health as much as men's health," she said. "We need to be our own advocates."