Coronary Artery Disease

Coronary artery disease (CAD) is a form of heart disease that occurs when plaque builds up in coronary arteries that supply blood to the heart muscles. When there is not enough blood, or when there is a complete obstruction of an artery, CAD can cause death of a portion of the heart muscle (a heart attack.)

Ask Your Doctor About Coronary Artery Disease in Women This pamphlet is to help you better understand the unique features of coronary artery disease in women and to help you ask your doctor what the appropriate medical care is for you.

What Are the Facts?

• Heart attacks are not just a man's problem.
• Nearly ten times as many women die of disease of the heart and blood vessels as of breast cancer.
• Coronary artery disease is different in women.
• Coronary artery disease is preventable.

Are You at Risk?

• AGE
  Between the ages of 45 and 65, CAD kills more women than breast cancer. By the time you're 60 you're as likely as a man to have a heart attack.
• FAMILY HISTORY
  If a brother, sister, or one of your parents has died before 55 of CAD, you are at increased risk.
• BODY SIZE
  If your weight is 30 percent above your ideal body weight, particularly if you collect fat around your waist rather than your buttocks or hips, you are at increased risk.
• UNHEALTHY LEVELS OF SERUM FATS
  High total cholesterol (over 200), low HDL (under 45) high triglycerides (over 200) and high LDL, or "bad" cholesterol (over 130) increase the risk of CAD.
• HIGH BLOOD PRESSURE
  Hypertensive women (those with blood pressure over 150/90) have increased risk for stroke, kidney and heart disease. As you age, your chances of developing high blood pressure are greater than a man's.
• DIABETES
  Diabetes increases women's risk for CAD four-to-six fold.
• MENOPAUSE
  Premature menopause (before the age of 38) increases your risk for CAD. Natural menopause is not a disease. But taking hormonal replacement therapy (HRT) may help keep good cholesterol (HDL) levels high if yours are too low (below 45 for women).

Does Your Lifestyle Put You At Risk?

• SMOKING
  Smoking is the single most important lifestyle factor for increasing risk of CAD.
• LACK OF EXERCISE
  You increase your risk by not including exercise in your life.
• STRESS: The combination of many responsibilities that are troublesome and unrewarding can lead to stress that increases the risk of CAD.
• BIRTH CONTROL PILLS
  If you smoke, oral contraceptives can increase your risk of CAD. In some women, oral contraceptives can produce high blood pressure, another risk factor for CAD.
• SUBSTANCE ABUSE
  Cocaine can give even teenagers a fatal heart attack.

How to Prevent a Heart Attack

• Stop smoking-—even one cigarette a day increases the risk.
• Exercise-—make sure you do at least 40 minutes of brisk walking at least 3 times a week.
• Eat right—lower fat intake in you diet. Reduce stress in your life.
• Keep blood sugar under tight control if you are diabetic.
• Consider HRT if you have low HDLs and two other risk factors for CAD.

SEE YOUR DOCTOR IF YOU HAVE:

• Pain in chest, back or upper abdomen accompanied by nausea, sweating and/or shortness of breath.
• A feeling of indigestion when you exert yourself or become excited.
• Dizziness or fainting.
• Palpitations.

ASK YOUR DOCTOR IF YOU NEED:

A stress echocardiogram (the preferred initial stress test for CAD in women) or a stress thallium test. If these are suggestive of disease, ask your doctor if you should have a cardiac catherization. Medicine to control high fat levels in your blood Hormonal replacement therapy to help correct low HDL levels. Aggressive correction of blocked coronary arteries with an intervention such as angioplasty or coronary artery bypass surgery.

If you think you are having a heart attack, don't wait. Call your doctor immediately or go to the nearest emergency room.

Prompt treatment can save your life.

This brochure contains the opinions and ideas of the Partnership for Women's Health and is designed to provide useful advice regarding heart disease. The Partnership for Women's Health disclaims any responsibility for any liability, risk, or loss, personal or otherwise that is incurred as a consequence directly or indirectly of the use and application of any of the contents.

Reprinted on the Web by permission of Procter & Gamble. Procter & Gamble and Columbia University College of Physicians and Surgeons are the founders of the Partnership for Women's Health at Columbia.