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What More Women Need to Know About Heart Disease

It's the leading killer of women nationwide, especially African-Americans and Hispanics. Learn how to reduce your risk — before it's too late.

By Andrea King Collier | February 14, 2013

Gail Alexander-Wright of Chesapeake, Va., knows firsthand how heart disease can change your life. One day in 2007, when she was in her mid-40s, she felt pain in her neck and chest. After a workout and dinner, she felt worse. "I couldn't talk. I had shortness of breath. And then I started vomiting," says Alexander-Wright, who had just become one of the 435,000 American women who have a heart attack each year, according to the Women's Heart Foundation.

Getting help in time saved her life, but Alexander-Wright was shocked. "As far as I knew, I didn't have any of the risks," she says. (Later, however, she discovered there was a history of heart attacks on her father's side of the family.)
 
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Nichelle Hoskins, 46, a freelance writer and fitness instructor in Birmingham, Ala., has had three heart attacks. The first time, in 2003, "I was walking in a breast cancer fundraiser when I had Fred Sanford-like chest pains," she says. "But they passed so I kept walking."

Later, an angioplasty revealed that Hoskins had an 80 percent blockage in one of her three major coronary arteries. "The doctors said I had what they call 'the widow maker,' the same type that Tim Russert died from in 2008," she says. Surgeons put in three stents to open up Hoskins' arteries, but three months later, she had a second heart attack and got three more stents.

Her third attack, in 2009, happened while she was walking uphill, pushing a lawnmower. "It was a familiar tightness, so I took an aspirin and waited," she says. "Then I finished cutting the grass and after calling my doctor, I drove myself to the hospital." Doctors there found blockage in another major coronary artery. Hoskins is now on a daily dose of statins and baby aspirin. Her doctor also recommended she stick to a plant-based diet, though she eats meat in moderation.
 
The Risks for Women of Color

Heart disease affects 43 million women nationwide, according to the American Heart Association, and is the leading cause of death for women in the United States. Deadlier than all forms of cancer combined, it claims the life of a woman every minute.

And yet, too many women are unaware of the seriousness of their risks: Only 20 percent of American women believe heart disease is their greatest health threat. There's also a lingering perception that it's primarily a male concern, even though more women than men have died of heart problems since 1984.

Women with diabetes, peripheral arterial disease and kidney disease run the same risk of having a heart attack as someone who has already had one. Other major risk factors include high blood pressure, poor diet, limited exercise, smoking, high cholesterol and a family history of heart disease (especially early heart attacks). In Hoskins' case, her maternal grandfather died of a heart attack and her father has arterial blockage. (She also believes that stress contributed to her heart problems.)

African-American women, like Hoskins and Alexander-Wright, are especially at risk, along with Hispanic women, because they have higher rates of elevated blood pressure and cholesterol as well as diabetes. On average, they develop heart disease about a decade earlier than Caucasians and are more likely to die at an earlier age. Further, African-American women have almost double the risk of stroke than whites.

Women of color need to be aware of their risk factors — and work to address them — before they turn 50, says Dr. Leslie Cho, director of women's cardiovascular health at the Cleveland Clinic. Regular checkups are a good first step, she says. "Know your blood pressure and cholesterol numbers and keep track of them," Cho advises.

Preventive steps, like giving up smoking and switching to a healthier diet, are also crucial. "African-American and Hispanic diets can be salty and fatty," she says, and the accumulated effects of unhealthy meals can lead to heart disease. According to the U.S. Department of Health and Human Services, 4 out of 5 African-American women are overweight.

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Exercise is another key to maintaining heart health. "Get at least 20 minutes most days," Cho says, adding that walking at a leisurely pace is not good enough. "You have to get your heart rate up and break a sweat to make a difference."

"Put your health first," says Alexander-Wright, now a spokeswoman for the heart association's Go Red for Women campaign. "We love our curves and fabulousness, but we have to understand that heart disease is an epidemic for us. We often use not wanting to mess up our hair as a reason not to exercise, but we'll spend much more on the costs of care after a heart attack."

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Know the Symptoms

It's important for all women to understand the symptoms of a heart attack, which can be different and more subtle than the cardiac distress signals experienced by men. Like Alexander-Wright and Hoskins, you may not realize right away that you've had an attack.

Many women, for example, will not feel the intense chest pressure that's often a telltale sign of a cardiac event. Instead, they may notice shortness of breath, some pressure or pain in the chest or upper abdomen, dizziness, lightheadedness or fainting, back pressure or extreme fatigue. If you feel any of these symptoms, Cho says, take them seriously and see a doctor.
 
(MORE: How to Save a Life and Make Sure Someone Can Save Yours)

After three heart attacks, Hoskins, who now works with the National Coalition of Women With Heart Disease, knows better than most the challenges of living with the condition. "I am conscious of it, but I don't walk on eggshells," she says. "I talk about what happened to me because I want to help other women. A lot of black women, those of us who have to work for a living, diminish our symptoms. We take it for granted that our aging comes with pain. But if you get a diagnosis, be aggressive and assertive when it comes to your own care."
 
8 Heart Healthy Tips

  1. Don't smoke.
  2. Maintain a healthy weight. Being overweight or obese raises your risk for heart disease, stroke and many cancers.
  3. Tweak your diet. Eat more fruit and vegetables; cut back on fatty and salty foods.
  4. Get moving. Make exercise a part of your daily lifestyle.
  5. Reduce your stress. If you can't, then change how you respond to it: Start doing yoga, learn to meditate or commit to exercising when your stress rises.
  6. Know your numbers. Take action to get your blood pressure, cholesterol and glucose numbers in a healthy range — it'll go a long way toward lowering your risk of heart disease.
  7. Understand your family's health history so you can take steps to reduce your risk factors. True, you can't change your age or race, but there are many other steps you can take to lower the odds.
  8. Know the warning signs of a heart attack, such as sudden tiredness, pain or numbness in the chest or an arm, nausea or jaw pain. If you feel any of these signs, seek medical attention immediately. The quicker you get help, the better the chance you'll survive.
Andrea King Collier is a multimedia journalist and lead author of The Black Woman’s Guide to Black Men’s Health.

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