Heart disease and stroke are the number one killers of women in the U.S. If you add up all the deaths from every type of cancer, they still don't equal the half a million deaths from heart disease and stroke every year. Heart attack and stroke are both caused by atherosclerosis (diseased arteries) and have the same risk factors.

Even though we know that one in two women will die of heart disease and stroke, women still underestimate their own risk: only 14% believe it will happen to them. Physicians have also traditionally underestimated women’s risks of having a heart attack – only 50% of women are advised about their risk of heart attack or stroke based on their health history. This probably stems from the fact that until very recently, the medical community believed that heart attack in women was not as important an issue as heart attack in men, and the new findings have not yet caught up to medical practice.

In order to discuss your individual risk of heart disease and stroke with your doctor, you should know the facts about heart disease and stroke and which health problems put you at higher risk.

What you may not know is that even though more men have heart attacks than women, women are three times more likely to die after having a heart attack than men. Women have more strokes than men. Other alarming facts include:

• Women are three times more likely to have another heart attack after the first one than men are.
• Younger women who have a heart attack are twice as likely to die than men the same age who have had a heart attack.
• Women are less likely to get aspirin or clot-busting drugs in the emergency room when they come in with chest pain.
• Stress tests are less likely to be accurate in women than in men, especially if women don’t get a dye with the stress test to light up the heart and see where problems are.
• Women’s coronary vessels are smaller and stents may not be small enough – arteries that are blocked are more likely to stay open with stents.
• Women are more likely to get congestive heart failure after a heart attack.
• Black women are four times more likely to have a stroke than white woman and three times more likely to die from that stroke.

Risk factors for heart disease and stroke

The risk factors for heart disease are shared by men and women, but there are some significant differences. The top factors that men and women share, besides being overweight and having a family history, are:
 
Diabetes: When a woman develops diabetes, her risk of heart attack is higher than a man who develops diabetes.

Smoking: More women smoke than men. Women who smoke are 50% more likely to have a heart attack than men who smoke. Women who smoke and take birth control pills are at high risk of sudden death.

Hypertension: 50% of women over the age of 45 have hypertension, which plays an important role in stroke. One third of people with hypertension don’t know they have it, and of those who are on medicine, less than one-quarter are adequately treated.

High cholesterol: 25% of women have abnormal cholesterol levels, but a staggering 70% don’t know their levels.

Other factors that appear to play a role in women only are:

• Untreated hypothyroidism, which occurs in up to 12% of older women
• A history of irregular menstrual cycles, or Polycystic Ovary Syndrome
• Developing diabetes in pregnancy
• Early menopause, or hysterectomy

Heart attack & stroke ARE preventable in women

The most important things that you can do right now to lower your risk are to eat healthy foods, increase physical activity, lose weight and stop smoking. Learn as much as you can about the factors that contribute to heart disease and stroke and bring them up at your doctor's visit.