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Heart Disease Risk Factors, Symptoms and Prevention for Women


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by Dr. Gregory Schuchard, board certified cardiologist

Heart disease is the #1 killer of women in the United States, claiming the life of one woman every minute. Do you know your risk factors? What about heart disease symptoms? What can you do to prevent heart disease? INTEGRIS cardiologist Dr. Gregory Schuchard answers these questions, and more.

Risk factors

Dr. Schuchard explains that risk factors for heart disease are essentially the same for both sexes and include smoking, family history, diabetes, abnormal cholesterol, high blood pressure, obesity and sedentary lifestyle. The only difference in the sexes is the presence of estrogen for women. “A woman’s estrogen status is a risk factor. Prior to menopause, women produce sufficient amounts of estrogen to decrease their risk of heart disease. After menopause, or ovary loss, estrogen levels fall and thus their risk for heart disease increases.” And while smoking has always been a significant contributor to heart disease, Dr. Schuchard said. Cardiologists are now treating more women whose heart disease was brought on by smoking. “This is the result of a smoking boom for women which started after World War II. It’s now just catching up to them and they are catching up to men in that category,” he said.


A woman’s symptoms are often different from what people think of as classic heart disease symptoms and Dr. Schuchard said, cardiologists don’t really know why that is. “Men tend to experience pressure and pain, the elephant on the chest feeling, and often pain that radiates through the arm, and excessive sweating. Women’s symptoms however, can present as more of an ache, shortness of breath, dizziness or neck/shoulder discomfort. It makes it more difficult to evaluate and easier to miss the warning signs,” Dr. Schuchard explained. Dr. Schuchard noted that diabetics sometimes have no pain with a heart attack. So a woman with diabetes can be doubly difficult to diagnose in terms of heart disease. “A patient might have unusual symptoms, but because of their diabetes, it’s not at first connected to heart disease. That’s why we now look at those patients with a high index of suspicion.”

When should you seek treatment?

“Women suffering from chest discomfort, palpitations, shortness of breath, decrease in exercise ability, should talk to their family physician,” Dr. Schuchard said. “We find that women do tend to listen to their bodies more than men and seek treatment of symptoms of heart disease sooner. As a general rule women are less hesitant to ignore symptoms.”

Heart disease in Oklahoma

Dr. Schuchard confirmed that Oklahoma has particularly high numbers of both men and women suffering from heart disease and smoking is the biggest reason for that fact. “In Oklahoma we have a high population of smokers and they start at a very young age. It’s the most significant risk factor in heart disease followed by family history. When I say family history, I don’t mean your father who died in his 80s from a heart attack, I mean a family member who had a heart event at an early age.” And Dr. Schuchard dismissed the idea that e-cigarettes (also called vaping) are any safer.
“In terms of heart disease, e-cigarettes are not any safer, and should be avoided. They may be safer in terms of your cancer risk, since some of the carcinogens found in cigarettes aren’t present in the e-cigarettes. But the nicotine is still there and that’s what’s damaging to the heart.”
Another concern is the prevalence of diabetes in Oklahoma, Dr. Schuchard pointed out, explaining that it’s at an almost epidemic level in Oklahoma. Over the years, diabetes causes damage to blood vessels throughout the body. As a result, heart disease and stroke are two of the most important health risks for people with diabetes.


Dr. Schuchard said a good medical history, assessment of risk factors, and a cholesterol panel is key in the diagnosis of heart disease. “Your doctor will evaluate these and decide if further testing is needed and what type of testing is best for you.” Many people routinely have a heart scan. These scans measure a person’s calcium score. Dr. Schuchard weighed in on the value of this particular test. “This type of test, on its own, isn’t particularly valuable because although it is good at detecting calcium in vessels, it doesn’t actually identify artery blockages. So, someone might have this screening done and have a very low calcium score, but might have significant cholesterol blockages. Or a person might have a high calcium score, but that calcium is collecting around the edges of the vessel and not impacting blood flow. However a high calcium score would be considered another risk factor.”


Dr. Schuchard concluded by offering this advice to a woman (or anyone) who wants to keep their heart healthy. “Deal with the risk factors you can modify. You can’t do anything about your family history but you can address smoking, weight, diet, and exercise. And it’s important not to ignore symptoms.” He said.

Get help

If you have heart disease or feel you’re at risk for a heart attack, visit INTEGRIS Heart Health.

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