The Healthy Heart Handbook for Women, NHLBI

The Healthy Heart

You owe it to yourself to take this handbook to heart. For heart disease is a woman's concern. Every woman's concern. It is not a condition that only affects your husband, your father, your brother, or your son. This handbook tells you why you should be concerned about your own heart health, and what you can do to prevent heart disease. If you now have heart disease, this booklet also suggests lifestyle changes that can help you protect your health. For every woman, a little prevention can have a big payoff - a longer, healthier, more active life.

Each year, 370,000 women die of coronary heart disease, making it the number one killer of American women. Another 93,000 women die each year of stroke. Although death rates from heart disease and stroke have declined in recent years, these conditions still rank first and third, respectively, as causes of death for women.

Overall, about 9 million American women of all ages suffer from heart disease. One in ten women 45 to 64 years of age has some form of heart disease, and this increases to one in four women over 65. Each year, a half million women suffer heart attacks. Cardiovascular diseases and their prevention, therefore, are pressing personal concerns for every woman.

What Are Cardiovascular Diseases?

Cardiovascular diseases are diseases of the heart and blood vessel system, such as coronary heart disease, heart attack, high blood pressure, stroke, angina (chest pain), and rheumatic heart disease. Coronary heart disease--the primary subject of this handbook--is a disease of the blood vessels of the heart that causes heart attacks. A heart attack happens when an artery becomes blocked, preventing oxygen and nutrients from getting to the heart. A stroke results from a lack of blood to the brain, or in some cases, bleeding in the brain.

Who Gets Cardiovascular Diseases?

Some women have more "risk factors" for cardiovascular diseases than others. Risk factors are traits or habits that make a person more likely to develop a disease. Some risk factors for heart-related problems cannot be changed, but others can be. The three major risk factors for cardiovascular disease that you can control are cigarette smoking, high blood pressure, and high blood cholesterol, overweight, and physical inactivity.

Other risk factors, such as diabetes, also are conditions you have some control over. Although growing older is a risk factor that cannot be changed, it is important to realize that other risks can be reduced at any age. This handbook identifies some key risk factors that you can do something about, and suggests changes in living habits to prevent or control cardiovascular diseases.

Some groups of women are more likely to develop cardiovascular diseases than other groups. African-American women are 60 percent more likely to die of coronary heart disease than white women, and their death rate for stroke is 24 percent higher. Older women have a greater chance of developing cardiovascular diseases than younger women, partly because the tendency to have heart-related problems increases with age. Older women, for example, are more likely to develop high blood pressure and high blood cholesterol levels, to be diabetic, to be overweight, and to be less physically active than younger women.

Also, after menopause, women are more apt to get cardiovascular diseases, in part because their bodies produce less estrogen. Women who have had early menopause, either naturally or because their ovaries have been surgically removed, are twice as likely to develop coronary heart disease as women of the same age who have not begun menopause.

While any one risk factor will raise your chances of developing or worsening heart-related problems, the more risk factors you have, the more concerned you should be about prevention. If you smoke cigarettes and have high blood pressure, for example, your chance of developing coronary heart disease goes up dramatically. If you smoke, have high blood pressure, and also have high blood cholesterol, your risk to five times higher than that of women who have no risk factors.

Changing habits isn't easy--but experience shows that it works. As Americans have learned to control blood pressure and make healthful changes in their eating, smoking, and exercise habits, death rates for heart attack and stroke have dropped dramatically. Between 1984 and 1994, the death rate from coronary heart disease declined 27 percent for white women and 23 percent for African-American women.

Cardiovascular diseases remain the leading cause of death for American women. But the message is clear: By taking an active role in your own heart health, you can make a difference. Beginning with the chapter on "Self-Help Strategies for a Healthy Heart," this handbook supplies a number of practical tips to help you get started. Also, for information about other organizations and materials available to help you, see "Resources for a Healthy Heart" on page 99.

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