Understanding Heart Disease
Cardiovascular disease is the number one cause of death in American women, accounting for almost 500,000 deaths each year. Even though it has been a major cause of death for women since 1908, cardiovascular disease only reached the public's attention in 1991, when it was realized that the number of deaths attributed to cardiovascular disease in women actually surpassed the number of deaths in men since 1984! Since then, a number of educational programs have been started to raise the awareness of the public.
The American Heart Association has labeled heart disease in women as the "silent epidemic". It is an epidemic because if affects one in nine women over the age of 45 years; by age 65 years, heart disease affects one in three women. Yet it is silent, as women are still unaware of how common this disease is. A 1995 Gallup Survey of women between the ages of 45 and 75 years revealed that 4 out of 5 women were not aware that heart disease was their number one cause of death! Most responded that cancer, especially breast cancer, was their most common threat. Another survey revealed that almost three-fourths of women thought that their chance of developing heart disease was less than 1% by 70 years of age, when it is really greater than 35%. These misconceptions prevent women from gaining the knowledge they need to reduce their risk of suffering from their greatest threat.
Identification of the absence of significant cardiovascular disease is as crucial as the accurate diagnosis of its presence. Women have more chest symptoms that are not related to traditional blood vessel blockages. This has confused the situation and misled physicians as well as women themselves. Traditional stress tests are inaccurate and show false abnormalities in about 40% of premenopausal women and up to 60% of postmenopausal women tested, even if they do NOT have heart disease. Diagnostic testing relies solely on the EKG tracing is not gender sensitive and misleads both patients and their physicians. Patients must have confidence in their physicians' ability to chose the correct tests to perform and to interpret those test results properly in order to accept results that exclude disease. The Women's Heart Institute recognizes that gender sensitive evaluations are key to maintaining patient confidence.
Explanations and Expansions
Cardiovascular disease refers to the diseases affecting the heart and blood vessels of the body. There are many conditions included in cardiovascular disease.
 | Most people are familiar with coronary heart disease (CHD) which is caused by narrowing of the blood vessels serving the heart. This narrowing can progress and produce a lack of blood supply to the heart muscle served by the blood vessel and lead to chest pain or heart attack. |
| Atherosclerosis is the most common cause of this blood vessel narrowing. A similar process can narrow the blood vessels serving the brain (causing a stroke) or in the legs (causing pain with walking). |
| High blood pressure can damage the brain causing a stroke or lead to a heart attack or weakening of the heart muscle, called congestive heart failure. |
| Problems can occur in the heart's structure (chambers or valves) or with the heart beat which can be serious and need treatment. |
The Gallup Survey results are based on telephone interviews during February and March, 1995, with a national sample of 505 American women, ages 45 to 75 years, and 300 physicians practicing in the primary care specialties of: internal medicine, family practice, or OB/GYN. Survey questions for women included opinions on:
| the leading cause of death in women |
| warning signs and symptoms of heart disease in men and women |
| risk factors for heart disease in women and their comparison to those for men |
| confidence in their primary care physician's ability to accurately diagnose heart disease in women |
Survey questions for primary care physicians included opinions on the above, plus:
| a comparison with the prior year's number of women evaluated for coronary artery disease |
| a comparison with the prior year's number of women referred for cardiology consultations |
| the level of need for educational and communication programs aimed at increasing the primary care physicians' awareness of coronary heart disease in women |
| how informed they felt about their own knowledge about heart disease in women |
Gallup Survey Results |
||
| WHAT WOMEN AGES 45 TO 75 BELIEVE | WHAT PRIMARY CARE PHYSICIANS BELIEVE | ACTUAL FACTS |
|---|---|---|
| 4 out of 5 women surveyed do not know heart disease is their leading cause of death | 32% of physicians did not know heart disease is the leading cause of death in women. | Heart disease is the leading cause of death in American women. |
| Half of women surveyed do not know menopause increases their risk for heart disease. | 2 of 3 physicians think risk factors for heart disease are the same in men and women. | Women have different risk factors for heart disease. |
| 70% of women report warning signs for heart disease are the same in women and men. | 88% of physicians believe the signs and symptoms of heart disease are the same for women and men. | Women's symptoms of heart disease may often differ from men's. |
| 86% of women are confident in their primary care physician's ability to diagnose heart disease in women; 84% would go to a primary care physician to evaluate their risk for heart disease. | 78% of physicians have not increased the number of women referred for cardiology consultation; 68% report no change in the number of women evaluated for heart disease. | Primary care physicians hold the key to early detection and improved outcome. |
| 83% of women feel at least moderately informed about heart disease in women. | 89% of primary care physicians feel physicians need more education about heart disease in women; 42% believe that need is high or extremely high. | Primary care physicians and women need to know more about heart disease. |
Last updated on October 17, 2002.