February 24, 2021

What We Know about Women and Heart Health

Tom Neal

Tom Neal

By Tom Neal, RN, MBA, MHA

As research protocols have shifted, women have been included in heart disease research and important revelations emerged. We now know that women’s heart attack symptoms are often quite different from a man’s, yet heart disease remains the leading cause of death for both genders. In fact, even though men suffer more heart attacks, the heart attack death rate for women is higher.

Thankfully, the American Heart Association started focusing on clinical recommendations regarding women and heart disease specifically in the late 1990s. This culminated in the creation of the Women’s Cardiovascular Diseases Research and Prevention Act, a legal mandate whose goal was to intensify the battle against women’s cardiovascular diseases, in 1998. Research, prevention and treatment have all been transformed and accelerated by these efforts.
Other governmental bodies have followed suit. For example, the Food and Drug Administration’s (FDA’s) Office of Women’s Health (OWH) helps to ensure that research continues into how gender differences impact cardiovascular disease treatment, and the Food and Drug Administration (FDA) requires that women be included in drug studies and trials for medical devices, such as pacemakers.

An important part of creating better health outcomes for women with heart disease is raising awareness around how different heart symptoms manifest themselves in women. Though they still experience some of the same heart attack symptoms as men, such as chest pain, sweating and shortness of breath, there are stark differences as well; the sooner we’re all familiar with these distinctions, the less likely it will be that a women herself ignores them or that a clinician mistakes the symptoms as indicating something other than heart attack.

Women’s unique heart attack symptoms can include neck pain, jaw pain, nausea or vomiting, pain in the area between the shoulder blades and overall fatigue. Also interesting is that women are 30 percent less likely to experience chest pain than men (though it’s still the main symptom for both sexes).

We must remember, however, that, male or female, one can experience any blend of these symptoms, so it’s critical that we’re familiar with all of them. Then we can properly identify them as signs of heart attack. Simply, understanding what a heart attack’s symptoms are — and immediately seeking emergency treatment by calling 911 — is pivotal to surviving one.

Healthcare providers often use the phrase “Time is muscle” to describe that fact that every second counts when you’re having a heart attack. It’s a serious situation because the longer you wait to receive treatment, the longer your heart is deprived of essential oxygen. This means that you are at greater risk for suffering more irreversible damage to the heart muscle, and you have a lower likelihood of full recovery.

It’s always important to remember the role that healthy lifestyle choices play in preventing heart disease, too. Women should aim for 30 minutes of moderate aerobic exercise per day, which translates into walking at a brisk pace or going for a swim or bike ride, and eating a diet rich in nutrient-dense foods like fruits and vegetables, whole grains and lean protein. It’s also important to “know your numbers,” which greatly impact your heart disease risk. These numbers include your weight, cholesterol levels, blood glucose level and blood pressure. If you smoke, do all you can to quit, and if you’re not a smoker, don’t ever start.

Other daily habits to incorporate that support heart health include getting enough high-quality rest, which translates to about 7-9 hours of sleep each night, and managing stress so that it doesn’t overtake you. Exercise helps with this too, as does meditating, doing yoga, catching up with a friend or knitting — de-stressing techniques are different for everyone, just be sure to engage in some.

Another reality is that since women often serve as caregivers to so many others, from children and spouses to elderly parents, co-workers and neighbors, they tend to put themselves last on the “VIP list.” Studies bear this out in that women put off seeking care more than men when they experience heart attack symptoms, but unfamiliarity with heart attack symptoms is also at play. Women need to put themselves first when it comes to heart disease, learn about all the varied symptoms of heart attack, and routinely discuss their risk with their primary care physicians at each well-woman exam. And finally, by practicing habits that protect the heart, the risk for other conditions, like diabetes and high blood pressure, goes down as well.

Even though we have focused on women in this column, I want to stress that men should be equally vigilant in learning about heart health and heart attack symptoms, as well as staying intentional about never putting off care if they sense something is amiss.

February is American Heart Month, when we can all raise our awareness about heart disease and stroke. It’s a symbolic way to tie a string around our fingers and remember to do all we can — whether that’s upping our self-care or having a conversation with a female friend or family member about the symptoms of heart attack in women — to lower the incidence of heart disease for the women in our lives and our community.

Highlands-Cashiers Hospital aerial view

Tom Neal, RN, MBA, MHA, is the Chief Executive Officer and Chief Nursing Officer (CNO) of Highlands-Cashiers Hospital.

Highlands-Cashiers Hospital, a member of Mission Health, an operating division of HCA Healthcare, is a community hospital serving Macon, Jackson and the surrounding counties. Located on Highway 64 between the towns of Highlands and Cashiers, the hospital offers 24/7 emergency care, acute inpatient care, rehabilitation, as well as long-term care through Eckerd Living Center. Highlands-Cashiers Hospital has 24 beds for acute care services and 80 beds in the Eckerd Living Center. Ambulatory services are also available, including therapy services and primary care practices serving both Highlands and Cashiers.