What do you think is the biggest health problem for women? If you thought breast cancer, think again. Cardiovascular disease, which includes heart disease and stroke, is the single greatest cause of death in American women, and most people are unaware that more women than men die from cardiovascular disease each year. According to the Bermuda Heart Foundation, one in three fatalities is attributed to heart disease in Bermuda. It is important for women to realize that heart disease is not just a man’s disease.


Cardiovascular disease is usually due to atherosclerosis, a process where cholesterol, fatty substances, calcium and a clotting protein called fibrin — collectively known as plaque — build up on the inner walls of arteries. The arteries can become inflamed, hardened and narrowed. Plaque can break off and cause the formation of a blood clot inside the damaged vessel, causing a heart attack or a stroke. Procedures like bypass surgery and angioplasty can reopen a blocked artery but cannot “fix” a damaged heart. 


Symptoms of heart disease in women can be different than in men. Instead of the classic chest pain, signs of a heart attack for women may include shortness of breath, nausea/vomiting, and back or jaw pain. Other symptoms that women may present are dizziness, lightheadedness, pain in the lower chest or upper abdomen, and extreme fatigue.


However, according to the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention, almost two-thirds (64 percent) of women who die suddenly of coronary heart disease have no previous symptoms. This is why it is so important for women not to wait to take action and discuss with their doctors if they are at risk for cardiovascular disease. 


The good news is that heart disease can be often prevented or controlled. Prevention includes lifestyle changes and, sometimes, use of medications, if prescribed by a doctor. Taking action against heart disease begins with you, and knowing the risk factors gives you an advantage. You can reduce your risk factors by replacing unhealthy habits with healthier ones. Some recommendations are:

¥ Eat a diet rich in fruits and vegetables. Choose whole-grain, high-fiber foods. Consume fish, especially oily fish, at least twice a week. Limit intake of saturated fat, cholesterol, alcohol, sodium and sugar, and avoid trans fatty acids.

¥ Get active.

¥ Monitor your weight.

¥ Stop smoking.

¥ Manage your blood pressure.

¥ Control your cholesterol levels.

¥ Control your blood sugars (glucose). 

¥ If you had pregnancy-related diabetes or hypertension, keep close watch for risk factors.

¥ If you have a family history of heart disease, talk to your doctor.


Women have heart attacks on average seven to 10 years later than men, but even 30- to 40-year-old women can have them. By doing just four things — eating right, being physically active, not smoking and maintaining a healthy weight — women can lower their risk of heart disease by as much as 80 percent.


Content courtesy of Erin Michos, M.D., M.H.S., associate director of preventive cardiology at the Ciccarone Center for the Prevention of Heart Disease and associate professor of medicine at the Johns Hopkins University School of Medicine.