Western Connecticut Medical Group Female Cardiologists Address Heart Disease: Are the Sexes Created Equal?
Romantics tell us that two hearts can beat as one, but the truth is that male and female hearts march to the beat of different drummers. The male heart beats more slowly (72 beats a minute) than the female heart (80 beats a minute) and is larger (weighing in at an average 10 ounces vs. 8 ounces).
According to Cardiologist Susan Mani, MD, who leads the Women's Cardiac Program at Danbury Hospital, the differences aren't merely cosmetic. "Women differ from men both in their susceptibility to heart disease and in how the disease progresses once it takes hold," she said. "Heart disease is typically detected later in women than men. Despite the early warning that chest pain can give, women are more likely than men to be diagnosed with heart disease at a more advanced stage - when it's more difficult to treat. They also may dismiss symptoms as something other than cardiac and delay seeking treatment, even in the case of a heart attack," Dr. Mani explained.
Her colleague, Teresa Daniele, MD, a cardiologist at the Praxair Regional Heart and Vascular Center, agreed. "Women can often dismiss warning signs, and must be more assertive in recognizing the symptoms of a heart attack and seeking immediate care. Our cardiovascular team is working to continually improve the prompt, effective detection and care of heart disease for women, and help them overcome any reluctance to seek treatment."
More than 500,000 women will die this year in the United States from what many still consider to be a "man's disease." In some cases, however, women's unique risks are higher than that of men. Cardiologist Margaret Bond, MD, whose special interests include preventive cardiology and heart disease in women, said, cigarette smoking increases a woman's risk of heart disease more so than a man's. "Some studies suggest that smoking increases the risk of having a heart attack by more than 50% in women than in men," said Dr. Bond, adding that more women than men suffer from angina. "Angina pectoris is chest pain that occurs when clogged blood vessels starve the heart of oxygen, and can be a warning sign of increased risk of heart attack," she said.
In terms of diagnosing heart disease, exercise electrocardiography is less accurate for women. The widely used exercise stress test (used to detect blocked coronary arteries) produces a higher number of false-positive results in women, which may lead to unnecessary angiograms. In many cases, doctors now opt for exercise echocardiography - a test that uses ultrasound images - to evaluate coronary artery disease in women.
As a woman gets older, her risk of heart disease increases. "The loss of natural estrogen as women age may contribute to the higher risks of heart disease seen after menopause. Changes in the walls of the blood vessels also make it more likely for plaque and blood clots to form," Dr. Daniele explained, "and changes in cholesterol - a higher LDL or 'bad' cholesterol, or lower HDL or 'good' cholesterol - will also increase the risk."
So if menopause removes estrogen, why not consider hormone replacement therapy (HRT) to reduce women's risk for heart disease? "Years ago, research was thought to show that HRT could possibly reduce the risk of heart disease in women, but that is no longer the case. HRT has not shown benefits in studies of women with existing heart disease," noted Dr. Bond, "in fact; we are learning that some forms of HRT may be harmful in these women."
Dr. Mani said that despite the differences between men's and women's hearts, the sexes have one thing in common: Both can protect their hearts by controlling risk factors such as high cholesterol, high blood pressure, excess weight, smoking and lack of exercise. "First and foremost, 'traditional' risk factors for heart disease should be addressed after menopause," she said.
Women with the lowest risk of heart disease are those who:
- Avoid or quit smoking
- Lose weight and/or maintain their ideal body weight
- Exercise for more than 30 minutes more than three times per week
- Follow a diet low in saturated fat (less than 7% daily amount); low in trans-fat (partially hydrogenated fats such as margarine or shortening); and high in fiber, whole grains, legumes (such as beans and peas), fruits, vegetables, and fish
- Treat and control medical conditions such as diabetes, high cholesterol, and high blood pressure that are known risk factors for heart disease
Be Heart Smart
If you don't know your numbers - blood pressure, cholesterol, blood sugar, body mass index (BMI) - start the New Year off right. Make an appointment with your primary care physician, and learn more about ways to reduce your risk for heart disease. To Find a Doctor or learn more about cardiovascular care at Danbury Hospital, visit online at DanburyHospital.org or call 1-800-516-4743.
About Western Connecticut Health Network
Western Connecticut Health Network is the region's premier, patient-centered health care organization serving residents of Western Connecticut and adjacent New York. The organization is anchored by two nationally recognized hospitals, Danbury Hospital and New Milford Hospital, as well as their affiliated organizations. In addition to the two hospitals, the continuum of care offered includes the following affiliates:
- Western Connecticut Medical Group, an integrated physician practice with primary and specialty care expertise
- Western Connecticut Home Care, an agency for home care and community health services
- The Western Connecticut Health Network Foundations
- emergency medical and Level II trauma services
- an occupational wellness and medicine program, providing services for business and industry
- a nationally renowned Biomedical Research Institute
Western Connecticut Health Network has centers of excellence in women's health, cardiovascular and cancer services; minimally invasive joint and spine surgery; digestive disorders, weight-loss (bariatric) surgery, and radiology and diagnostic imaging. It also offers specialized programs for neonatology with a Level IIIb neonatal intensive care unit and accredited sleep disorder centers. Both hospitals also maintain active clinical research programs, offering clinical trials for patients with cancer and other health concerns. Danbury Hospital was named a Top 100 Hospital by US News and World reports in 2012; a and a Top 100 for Value by Cleverly and Associates. New Milford Hospital is well known as a Planetree hospital and for its Plow to Plate, farm to table food program.
For more information, visit WesternConnecticutHealthNetwork.org, DanburyHospital.org; NewMilfordHospital.org and share your comments with us at Facebook.com/DanburyHospital or Facebook.com/NewMilfordHospital.