Women & Heart Disease

By Warren W. Chin, M.D.

(printed in the February issues of World Journal and Sin-Tao Daily)

Every year 500,000 women died of heart disease.  It is the number one cause of death in women in America as well as in the Chinese community.  However, only 8% of American women understand that cardiovascular disease in their greatest health threat.  A woman is ten times as likely to die of heart disease as from breast cancer.  Since 1984, the number of cardiovascular deaths for female exceeded those for males, and the gap in death continues to increase each year.  The number of cardiovascular deaths has declined in men but has actually increased in women over the last decade, most of this increase is due to ischemic heart disease and ischemic strokes.  Misconceptions still exist that cardiovascular disease is not a real problem for women.  A woman’s greatest risk is ignorance.  The Red Dress campaign by the American Heart Association has been started two years ago to raise both public and physician awareness.

 By the time women are diagnosed with coronary artery disease, women are likely than men to have advance disease.  More women than men will die within one year after a heart attack.  Women also have higher in hospital mortality after coronary angioplasty and coronary artery bypass surgery.  Diagnosis of heart disease also presents a greater challenge in women.  Clinicians and patient often attribute chest pain in women to non-cardiac causes.  Women may have a greater tendency than men to have atypical chest pain presentation such as abdominal pain, dyspnea, nausea or unexplained fatigue.  Women may also avoid or delay seeking medical care, perhaps partly due to denial or their lack of awareness of typical and atypical heart attack symptoms.  Some diagnostic tests and procedures may not be as accurate in women.

 Women should learn the major risk factors of coronary artery disease, such as cigarette smoking, hypertension, hypercholesterolemia, diabetes, physical inactivity and obesity.  They have to learn to reduce the blood pressure, cholesterol, control or delay the onset of diabetes, quit smoking, reduce the excessive weight or maintain a healthy weight and to reduce the use of alcohol.  They should learn to recognize the warning signs of heart attacks, such as chest discomfort, discomfort in other areas of the upper body such as one or both arms, the back, neck, jaw or stomach, shortness of breath, cold sweat, nausea or lightheadedness.  If they experience these symptoms, they should call 911 or go to the hospital right away to avoid any delay in treatment which can be lifesaving.

 婦女與心臟病

陳建樂醫生

美國每年有50萬婦女死於心臟病。  在美國以及華埠， 它都是導致婦女死亡原因中的首位。  但只有8%的美國婦女認識到心血管疾病是她們的最大健康威脅。  婦女死於心臟病的可能性是死於乳癌的可能性的十倍。  自1984年以來，死於心血管疾病的女性人數比男性要多，且男女死於心血管疾病的人數差距在逐年擴大。  在過去的十年中，男性死於心血管疾病的數量在下降，但女性死於心血管疾病的數量在增加，且大多數女性是死於缺血性心臟病和缺血性中風。  “心血管疾病並不是婦女的嚴重健康問題”的這一錯誤觀念仍然存在。  對此缺乏瞭解， 就是婦女健康的最大危險。  美國心臟協會自兩年前開始舉辦紅衣服運動，目的是提高公衆和醫生對心臟病的認識。

 與男性相比， 當女性被診斷爲患有冠狀動脈硬化性心臟病時, 更有可能已發展到了病情的晚期。  女性在心臟病發作後的一年內死亡的人數要多於男性。  女性在接受冠狀血管成形術及冠狀動脈旁路術之後在醫院內死亡的比率也高於男性。  婦女患心臟病也較難得到確診。臨床醫生和患者常常將女性的胸痛歸因於心臟病以外的其他原因。  女性比男性更易出現非典型胸痛表現，例如表現為腹痛，呼吸困難，噁心或無法解釋的疲勞。  婦女也可能會避免求醫或拖延求醫時間， 這在一定程度上可能是由於她們不願意承認自己患病所導致，也可能是因為她們缺少對心臟病發作的典型和非典型症狀的認識。  一些化驗和檢查方法對於女性來說可能沒有對男性那樣精確。

 女性應該瞭解冠狀動脈病的主要危險因素，如吸煙，高血壓，血膽固醇過多，糖尿病，缺少運動及肥胖症。  她們必須學習降低血壓，膽固醇，控制或延遲糖尿病發病，戒煙，減去身體超重重量， 保持健康體重，及減少飲酒量。  她們應該學習識別心臟病發作的前兆如胸部不適，上身其它區域如一只手臂或雙臂，背部，頸部，下顎或胃部的不適，氣短，出冷汗，噁心或頭昏眼花。  如果出現這些症狀，她們應該撥打911或馬上去醫院，挽救自己的生命。