An Equal Opportunity Killer

The latest studies show a surprising picture. When you compare statistics, you find that heart attack is the No. 1 killer of American women. Of the nearly 500,000 heart attack deaths that occur each year, over 233,000 are women, and more than 87,000 women die each year of stroke. By comparison, about 43,000 women die each year from breast cancer and over 55,000 from lung cancer.

On a larger scale, all heart and blood vessel diseases combined claim more than 479,000 women's lives each year. That compares with about 245,000 for all forms of cancer.

It's true that more men have heart attacks than women and men have them earlier in life. But women have lower chances of surviving them. Studies show that 44 percent of women die within a year compared to 27 percent of men. During the first four years following a heart attack, the rate of having a second attack is 20 percent for women compared with 16 percent for men.

The Cause of Heart Attacks

A heart attack occurs when the supply of blood to part of the heart muscle itself is severely reduced or stopped. It happens because one or more of the coronary arteries that supplies blood to the heart is blocked. Depending on how long the blood supply is cut off, the muscle cells in that area of the heart suffer permanent damage or die.

Heart attacks result from blood vessel disease in the heart, called coronary heart disease. It also may be referred to as coronary artery disease. Diseases of the heart and blood vessels are known as cardiovascular diseases. Other major ones include stroke (or "brain attack"), rheumatic heart disease, and hypertension (high blood pressure).

Silent Epidemic

One in eight women aged 45 and over has had a heart attack or stroke. More than 20,000 women under age 65 die each year of heart attack; over 30 percent of them are under age 55.

Among black women the situation is worse than among white women:

*The 1992 age-adjusted death rate for coronary heart disease is 33 percent higher for black women than for white women.
* From ages 35 to 74, the death rate from heart attack among black women is 1.4 times that of white women.
*After age 85, death rates for white women are highest.

Clearly heart disease is epidemic in women as well as in men. The main difference between the sexes is not whether women are likely to get heart disease, but when. This isn't I commonly recognized because heart disease takes almost a decade longer to show up in women. By then, a woman is often concerned with other health problems she may have, such as cancer, arthritis, or osteoporosis. These diseases tend to draw attention away from the steadily ticking time bomb of heart disease.

But There Is Some Good News...

In spite of these gloomy statistics, Americans have made remarkable progress in the fight against heart attack and stroke.

*From 1963 to 1992 the age-adjusted death rate for coronary heart disease for the general population dropped 57 percent.
*During the same period the age-adjusted death rate for stroke dropped 65 percent.
*From 1965 to 1992 the overall age-adjusted death rate for cardiovascular disease declined 52 percent.

In the ten years from 1982 to 1992, the age-adjusted death rates for women declined by 28.7 percent for coronary heart disease, by 26.8 percent for stroke, and by 22.4 percent for all cardiovascular diseases.

This progress is due in part to advances in the diagnosis and treatment of heart patients. A greater focus on prevention has also helped. Many Americans are learning how certain lifestyle habits increase the risk of heart disease, and they're changing these habits to cut their risk. For example, in the United States, smoking has declined by more than 37 percent since 1965. Smoking among women has declined by 27 percent—more than one of every four women who smoked regularly in 1965 have quit. The dietary cholesterol intake of the American public has declined to an average of 220-260 mg per day for women and 360 mg per day for men.

These gains give us another kind of good news: If we take control of our lives and choose habits that promote heart health, we can help prevent heart disease.

Sadly, heart and blood vessel diseases are still the leading cause of death for American women as well as men. Almost half of us will die this way, unless we choose to take steps to help prevent it.

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