Heart disease is the leading cause of death among women.
- An estimated 90% of women have at least one risk factor for heart disease.
- Heart attack symptoms can be different for women than for men.
- Younger women with heart disease are more likely to die than men of the same age with heart disease. It is especially important for women and their doctors to be aware of early risk detection for primary prevention.
- Despite being the #1 killer, only 13% of women surveyed by the American Heart Association (AHA) thought heart disease was their biggest health risk. Awareness may be a barrier to timely assessment and treatment.
- Only 6% of Fellows of the American College of Cardiology (FACC cardiologists) are women.
- Cardiovascular disease (CVD) can be prevented and reversed with lifestyle changes.
What is cardiovascular disease (CVD)?
Cardiovascular disease includes a large number of unique conditions that can affect not only the heart but also the blood vessels throughout the body including those in the brain (stroke) and extremities (peripheral artery disease). Within the heart, disease can affect the physical structure including the valves (for example, congenital mitral valve prolapse or rheumatic heart disease caused by strep infections) or the muscle wall (for example, cardiomyopathy or congestive heart failure). Cardiovascular disease also includes conditions of vascular function (for example, endothelial dysfunction, angina, or hypertension), inflammation (for example, endo- or myocarditis), or the electrical regulation of the heartbeat (for example, arrhythmia or atrial fibrillation).
What is atherosclerosis?
One type of cardiovascular disease includes physical blockages that can stop blood flow in the coronary vessels and cause ischemia of the heart muscle. When this is severe and sudden, this is what is commonly referred to as myocardial infarction or a "heart attack." However, years of coronary artery disease typically precede the attack with gradual narrowing and blocking of the blood vessels. The blockages are formed by lipid or cholesterol deposits that cause inflammation and form plaques. These plaques calcify, block the vessels, and limit blood flow to the heart muscle. This process is called atherosclerosis. The plaques can also rupture, releasing a thrombus or clot that can block blood flow downstream and cause ischemia (decreased oxygen delivery to tissues) elsewhere in the heart or brain.
Because the body was not designed to have high levels of cholesterol (specifically LDL) in the blood, immune cells called macrophages move it into the blood vessel walls to get it out of the circulation. In this process, it becomes oxidized, and this is what triggers the inflammatory process. The macrophages become overwhelmed with the oxidized LDL, try to engulf it, becoming "foam cells." These foam cells trigger the need for further "clean up," and the body tries to sequester the unhealthy foam cells and forms a hard plaque around it. These plaques cause further inflammation within the tissue of the artery wall; this is how atherosclerosis progresses.
There are differences between how atherosclerosis develops in men and women. In general, women are more likely to have plaque formation in a single coronary vessel and in smaller blood vessels. Overall, atherosclerosis or obstructive cardiovascular disease is a less common form of heart disease among women, although when plaques do form, the plaques are comprised of lipid-filled foam cells, which are both more easily treated and reversed. However, the plaques in women are more likely to rupture than atherosclerotic plaques in men.