Reduced Estrogen Raises Heart Risk | Print |  E-mail
Thursday, 28 February 2013 15:20



Special to the Times

This year, coronary artery disease (CAD) will claim the lives of more women than any other disease. Too often, women are unaware that CAD is a serious health risk and don’t get evaluated for heart disease, even though it could save their lives.

Coronary artery disease

CAD is a type of heart disease that occurs when fat and cholesterol, known as plaque, buildup in the blood vessels that supply blood to the heart. The plaque causes narrowing in the blood vessels, which reduces the flow of blood. Most heart attacks occur when a blood clot forms on the plaque and cuts off the blood supply to the heart.

On average, women develop CAD 10 years later than men. This may be due to the protective role estrogen is thought to play in preventing heart disease.

When women go through menopause, their estrogen levels drop, which may place them at greater risk for coronary artery disease.

Same disease, different symptoms

Chest pain is a common symptom of CAD in both men and women, but they often experience it differently. Men tend to feel sharp chest pain during physical exertion, while in women, chest pain may occur with exertion or with mental stress alone. Women may also experience unexplained fatigue or shortness of breath.

What’s your risk?

Common risk factors in both men and women include smoking, high blood pressure, high LDL (low-density lipoprotein) cholesterol, low HDL (high-density lipoprotein) cholesterol, diabetes, lack of exercise.

African-American and Latina/Hispanic women have a greater prevalence of certain risk factors, so they tend to have a higher risk for coronary artery disease.

While both men and women can have high LDL cholesterol, women naturally have higher levels of the “good” HDL (high-density lipoprotein) cholesterol than men, which help to remove the “bad” LDL cholesterol from the arteries. So, low HDL levels in women are a serious risk factor for heart disease.


A cardiac stress test is often used to diagnose CAD in both men and women by monitoring the heart’s electrical activity and pumping performance. However, even when their hearts are healthy, women are more likely than men to show irregularities during cardiac stress tests. This can create a false positive for heart disease, so doctors also use an imaging test to confirm the results of stress tests in women.

If you are diagnosed with CAD, there are many effective medications and surgeries available that are equally successful in both men and women.

Heart health

Prevent a heart attack by catching heart disease before symptoms begin. Have your cholesterol and blood pressure levels checked regularly beginning at age 45. You can also reduce your risk for coronary artery disease by

• Maintaining a healthy weight

• Eating a diet low in fat, salt and simple sugars

• Exercising regularly (at least 30 minutes, five times a week)

• Quitting smoking

• Maintaining optimal cholesterol and blood pressure values

February is American Heart Month. Take the opportunity to talk with your doctor about your heart health.

Jeffrey A. West, M.D., FACC, is a cardiologist affiliated with Eden Medical Center.


CAPTION: Establishing a routine of regular exercise can reduce your risk for coronary artery disease.





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