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Why is
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WOMEN AND THEIR DOCTORS NEED TO BE MORE AWARE |
Although further studies are required, the symptoms of heart disease and
stroke appear to be different for women. Because research has been
traditionally based on male patient profiles, further information is
needed about risk factors, symptoms, diagnosis and treatment in women.
RISK FACTORS
SYMPTOMS
Do women wait too long to see a doctor because they're busy nurturing
everyone else in their family to stop and listen to their own bodies? Or
is it because their symptoms are different?
Men more often experience textbook cases of angina and other
heart-disease symptoms because textbooks primarily describe men's
symptoms.
Women may have less dramatic chest pain and they are more likely to have
neck and shoulder pain, nausea and/or shortness of breath when having a
heart attack.
DIAGNOSIS
Why is it difficult for doctors to determine a diagnosis for women?
It could be the difference in symptoms. Men will tell their doctor that
their angina comes on with stress or exertion and improves with rest;
this is known as classic or stable angina. Women will say it comes and
goes and in some cases doesn't really get better if they lie down. Their
angina is often atypical.
Or it could be that heart disease is not
always considered a female health concern. When a man goes to the
doctors office complaining of chest pains, the doctor immediately thinks heart
and orders tests. Facing women with similar chest pains, the same doctor
might arrive at another diagnosis.
Part of the problem with providing an accurate diagnosis for women is that medical science has yet to determine a classic or typical picture for women.
TREATMENT
And, when they are operated on, women are more likely than men to die.
The death rate for women following bypass surgery is about twice that
for men.
Higher death rates for women following surgery may be due to late
diagnosis of the disease and/or the diagnosis being made at an older age
than men. However, another theory suggests that women may be subject to
a different kind of heart disease, one that progresses at a different
rate than the kind that affects men. Whichever the case, only research
will provide an answer.
The same factors that apply to men i.e., smoking, family history, high
blood pressure, diabetes, obesity, lack of physical activity and high
cholesterol are also important for women. However, certain risk factors
are unique to women, such as menopause and using oral contraceptives in
conjunction with smoking.
Women often wait longer than men to report heart trouble and
subsequently their treatment starts later in the development of their
disease.
Establishing a diagnosis for heart disease in women can be difficult.
Even though women are experiencing symptoms, doctors and current
diagnostic tests may not always pick up indications of the disease.
Getting a proper diagnosis is often difficult for women but getting
treatment may be even more difficult. Why? Women's test results can
indicate a disease which is less severe than a man's; therefore
treatment may not be as aggressive in women. A number of studies show
that women are less likely to receive appropriate medications in the
emergency room, less likely to be transferred to specialty hospitals for
aggressive care and less likely to receive invasive treatments such as
bypass surgery and balloon angioplasty.
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HOW WE CAN WORK TOGETHER TO ATTACK DISCOURAGING STATISTICS |
Death rates for women from heart disease and stroke will only
decrease when women and the medical community have the right tools to
combat the disease. These tools are research and the promotion of a
healthy heart lifestyle.
RESEARCH
Are heart disease and stroke risk factors the same for women and men?
Why are risks of surgery greater for women than men?
Why are rehabilitation programs for heart disease and stroke less
effective in women?
How do oral contraceptives and hormones, such as estrogen, influence
various aspects of heart disease?
HEALTH PROMOTION
There is a need for gender-specific research. We need answers that may
help provide more effective diagnosis and treatment for women with heart
disease and stroke. Some of the current issues which may become the
focus for research include
In addition, education about preventing heart disease and stroke,
warning signs and effective treatment is required for women. The goal is
to teach women how to prevent heart disease. Lifestyle choices in early
life can have an effect on heart health in middle age and beyond. For
instance, studies have shown that women smokers who use oral
contraceptives are up to 39 times more likely to have heart attacks and
up to 22 times more likely to have strokes.
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IS HEART DISEASE & STROKE THE WOMEN'S HEALTH ISSUE OF THE 90's |
If you believe breast cancer or lung cancer is the leading cause of
death among Canadian women, you are mistaken. The most common cause of
death among women is heart disease and stroke. In 1995, these diseases
accounted for 39% of all female deaths in Canada - making it the Number
One Killer of women.
Women are eight times more likely to die of heart disease and stroke
than from breast cancer. And, at age 45, a woman's risk of death by
heart disease and stroke increases by four times.
But the real reason heart disease and stroke have become THE WOMEN'S
HEALTH ISSUE OF THE 90's is that, while many men are recovering from and
living with heart disease, women are dying before their time because
they do not know the risks.
Why is this the case and what can we do about it?
SIGNS OF HEART ATTACK
* heaviness, pressure, squeezing, fullness, burning discomfort or pain which may spread to the neck, jaw and shoulders, lasting for at least 10 minutes and not relieved by rest
* nausea and vomiting and/or indigestion
* shortness of breath, paleness, sweating or weakness
SIGNS OF STROKE
* sudden weakness or numbness and/or tingling of the face, arm or leg, which may last only for minutes
* Sudden trouble speaking or understanding speech
* sudden loss of vision, particularly in one eye, or double vision
* sudden severe, unusual headache
WHAT TO DO
Know the telephone number of your local emergency medical care system and use it immediately. You must have rapid 24-hour access to emergency medical care to increase your odds of survival.
Don't wait. Don't feel embarrassed. Remember that time is the single most effective way of improving your chance of living.
Be familiar with the signals. Call your local Heart and Stroke Foundation office to find out where you or a family member can take a CPR course.
* vague chest discomfort rather than the crushing, radiating chest pain men often describe
Any single symptom or combination of the above may be a signal of a heart attack or stoke. If you are experiencing these signals, don't deny them! Tell someone immediately - a family member, friend, neighbour, or call emergency help.
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