Risk Factors for Heart Disease

Risk Factors for Heart Disease


Although heart disease is often perceived as a health condition affecting men, it is also the leading cause of death for women in the United States. Approximately one-quarter of all deaths in women are due to heart disease. One in nine women develops heart disease symptoms between the ages of 45 and 64, according to the National Center for Health Statistics. After age 65, the ratio rises to one in three women.

While the most common symptom of heart disease is typically chest pain or pressure, other symptoms may indicate the presence of an underlying heart condition. These include shortness of breath, arm pain (right or left), nausea, lightheadedness, excessive fatigue, or pain that is more apparent in the neck, back, shoulders, or jaw.

Almost two thirds of women who die suddenly of heart disease have no previous symptoms. Thus, it is important to be aware of the risk factors for heart disease and work diligently to reduce the risk whenever possible. According to the American Heart Association and National Cholesterol Education Program, the primary cardiovascular risk factors in women include: (a) a personal history of cardiovascular disease; (b) age over 55; (c) elevated low density lipoprotein (LDL) cholesterol; (d) low high density lipoprotein (HDL) cholesterol; (e) family history of premature heart disease (first degree male relative under age 55 or female relative under age 65); (f) diabetes, smoking, or a personal history of peripheral artery disease. Other risk factors include high blood pressure, elevated triglycerides, obesity, and chronic kidney disease.

While risk factors such as family history and age cannot be changed, others are modifiable. It is important to refrain from smoking. This includes exposure to second hand smoke. Smoking has been shown to be associated with one-half of all cardiac events in women. Smoking cessation can significantly decrease this risk. In fact, the risk of cardiovascular events in women who have stopped smoking for three years almost drops to the risk in women who have never smoked.

Exercising regularly, maintain a healthy weight, and consuming a diet low in saturated fat is also important. Higher consumption of fruits, vegetables, legumes, fish, poultry, and whole grains along with lower intake of red and processed meats, sweets, fried foods, and refined grains has been shown to significantly lower the risk of cardiovascular disease in women.

Starting at age 20, every woman should be screened for cholesterol abnormalities with a blood test. At the time of screening, a blood test to screen for diabetes can also be done.

Diabetes is an important risk factor for heart disease, particularly in women. This risk may be independent of sugar control. In other words, diabetic patients whose blood sugars are controlled still need to take additional steps to manage an increased cardiovascular disease risk. This can be done through lifestyle modifications or through cholesterol-lowering statin medications. In women who have a high risk for heart disease, whether from diabetes or other causes, low dose aspirin therapy may be recommended by your physician.

It’s important to understand your risk for developing heart disease and the steps that you can take to reduce this risk. Remember to bring this up next time you see your primary care physician.

Basim Khan, MD, MPA is a primary care physician and executive director at Neighborhood Health. Neighborhood Health is a patient-centered medical home providing comprehensive primary health care, dental services, and behavioral health services to children, adults, and seniors in the City of Alexandria for more than 18 years. Reach Neighborhood Health by calling 703-535-5568 or visiting www.neighborhoodhealthva.org.