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Frequently Asked questions

Heart Disease
back. It can also feel like indiges-
tion (upset stomach). Angina is
not a heart attack, but having
angina means you are more likely
In 1991, I went to the to have a heart attack.
ER with chest pains Heart attack. A heart attack
twice in one week. occurs when an artery is severely
They said it was ulcers or completely blocked, and the
(bleeding in the stom- heart does not get the blood it
ach). Then the pain needs for more than 20 minutes.
http://www.womenshealth.gov became very intense. Heart failure occurs when the heart
1-800-994-9662 Again, the ER said there was nothing is not able to pump blood through
they could do. I refused to leave and the body as well as it should. This
TDD: 1-888-220-5446
was admitted for observation. Later, the means that other organs, which nor-
doctor on duty saw my EKG and asked, mally get blood from the heart, do
Wheres the 34-year-old who had the not get enough blood. It does not
massive heart attack? I had emergency mean that the heart stops. Signs of
surgery. But the damage was done; only heart failure include:
part of my heart muscle functions. I had
to quit a job I loved, and my life is com- Shortness of breath (feeling like
pletely changed. They thought I was too you can't get enough air)
young to have a heart attack. Swelling in feet, ankles, and legs
Extreme tiredness
Q: What is heart disease? Heart arrhythmias (uh-RITH-
A: Heart disease includes a number of mee-uhz) are changes in the beat
problems affecting the heart and the of the heart. Most people have
blood vessels in the heart. Types of felt dizzy, faint, out of breath or
heart disease include: had chest pains at one time. These
changes in heartbeat are harmless for
Coronary artery disease (CAD) most people. As you get older, you
is the most common type and is are more likely to have arrhythmias.
the leading cause of heart attacks. Don't panic if you have a few f lut-
When you have CAD, your arteries ters or if your heart races once in
become hard and narrow. Blood has a while. If you have f lutters and
a hard time getting to the heart, so other symptoms such as dizzi-
the heart does not get all the blood it ness or shortness of breath, call
needs. CAD can lead to: 911 right away.
Angina (an-JEYE-nuh).
Angina is chest pain or discom-
fort that happens when the heart
Q: Do women need to worry about
does not get enough blood. It heart disease?
may feel like a pressing or squeez- A: Yes. Among all U.S. women who die
ing pain, often in the chest, but each year, one in four dies of heart dis-
page 1 sometimes the pain is in the ease. In 2004, nearly 60 percent more
shoulders, arms, neck, jaw, or women died of cardiovascular disease

U.S. Depar
Department
tment of Health and Human Ser
Services,
vices, Office on Women
omenss Health
Frequently Asked questions

(both heart disease and stroke) than Q: What can I do to prevent heart
from all cancers combined. The older disease?
a woman gets, the more likely she is A: You can reduce your chances of getting
to get heart disease. But women of all heart disease by taking these steps:
ages should be concerned about heart
Know your blood pressure. Years
disease. All women should take steps to
of high blood pressure can lead
prevent heart disease.
to heart disease. People with high
Both men and women have heart blood pressure often have no symp-
attacks, but more women who have toms, so have your blood pressure
heart attacks die from them. Treatments checked every 1 to 2 years and get
http://www.womenshealth.gov can limit heart damage but they must treatment if you need it.
1-800-994-9662 be given as soon as possible after a heart
Dont smoke. If you smoke, try to
attack starts. Ideally, treatment should
TDD: 1-888-220-5446 quit. If youre having trouble quit-
start within one hour of the first symp-
ting, there are products and pro-
toms.
grams that can help:
If you think youre having a heart
attack, call 911 right away. Tell the Nicotine patches and gums
operator your symptoms and that you Support groups
think you're having a heart attack.
Programs to help you stop smok-
ing
Q: Do women of color need to Ask your doctor or nurse for help.
worry about heart disease? For more information on quitting,
A: Yes. African American and Hispanic visit Quitting Smoking.
American/Latina women should be
Get tested for diabetes. People
concerned about getting heart disease
with diabetes have high blood glu-
because they tend to have more risk
cose (often called blood sugar).
factors than white women. These risk
People with high blood glucose
factors include obesity, lack of physical
often have no symptoms, so have
activity, high blood pressure, and diabe-
your blood glucose checked regu-
tes. If youre a woman of color, take
larly. Having diabetes raises your
steps to reduce your risk factors.
chances of getting heart disease. If
you have diabetes, your doctor will
decide if you need diabetes pills or
Take action to reduce heart disease
insulin shots. Your doctor can also
risk:
help you make a healthy eating and
1. Be physically active exercise plan.
2. Dont smoke Get your cholesterol and trig-
3. Eat healthy lyceride levels tested. High blood
4. Maintain a normal weight cholesterol (koh-LESS-tur-ol) can
clog your arteries and keep your
5. Know your numbers (blood pressure,
heart from getting the blood it
cholesterol, and triglycerides)
needs. This can cause a heart attack.
page 2 Triglycerides (treye-GLIH-suh-

U.S. Department of Health and Human Services, Office on Womens Health


Frequently Asked questions

ryds) are a form of fat in your blood Q: What does high blood pressure
stream. High levels of triglycerides have to do with heart disease?
are linked to heart disease in some A: Blood pressure is the force your blood
people. People with high blood cho- makes against the walls of your arteries.
lesterol or high blood triglycerides The pressure is highest when your heart
often have no symptoms, so have pumps blood into your arteries when
both levels checked regularly. If your it beats. It is lowest between heart beats,
levels are high, talk to your doc- when your heart relaxes. A doctor or
tor about what you can do to lower nurse will write down your blood pres-
them. You may be able to lower sure as the higher number over the
http://www.womenshealth.gov
your both levels by eating better and lower number. For instance, you could
exercising more. Your doctor may have a blood pressure of 110/70 (read as
1-800-994-9662
prescribe medication to help lower "110 over 70"). A blood pressure read-
TDD: 1-888-220-5446 your cholesterol. ing below 120/80 is usually considered
Maintain a healthy weight. Being normal. Very low blood pressure (lower
overweight raises your risk for heart than 90/60) can sometimes be a cause of
disease. Calculate your Body Mass concern and should be checked out by a
Index (BMI) to see if you are at a doctor.
healthy weight. Healthy food choices High blood pressure, or hypertension,
and physical activity are important to is a blood pressure reading of 140/90 or
staying at a healthy weight: higher. Years of high blood pressure can
Start by adding more fruits, veg- damage artery walls, causing them to
etables, and whole grains to your become stiff and narrow. This includes
diet. the arteries carrying blood to the heart.
As a result, your heart cannot get the
Each week, aim to get at least 2
blood it needs to work well. This can
hours and 30 minutes of moder- cause a heart attack.
ate physical activity, 1 hour and
15 minutes of vigorous physi- A blood pressure reading of 120/80 to
cal activity, or a combination of 139/89 is considered prehypertension.
moderate and vigorous activity. This means that you don't have high
blood pressure now but are likely to
If you drink alcohol, limit it to develop it in the future.
no more than one drink (one 12
ounce beer, one 5 ounce glass of
wine, or one 1.5 ounce shot of Q: How can I lower my blood pres-
hard liquor) a day. sure?
A: If you have hypertension or prehyper-
Find healthy ways to cope with
tension, you may be able to lower your
stress. Lower your stress level by
talking to your friends, exercising, or blood pressure by:
writing in a journal. losing weight if you are overweight
or obese
getting at least 2 hours and 30 min-
utes of moderate physical activity or
page 3 1 hour and 15 minutes of vigorous
activity each week.

U.S. Department of Health and Human Services, Office on Womens Health


Frequently Asked questions

limiting alcohol to one drink per day Q: What do my cholesterol and


quitting smoking if you smoke triglyceride numbers mean?
A: Total cholesterol level - Lower is
reducing stress
better. Less than 200 mg/dL is best.
following the DASH (Dietary
Approaches to Stop Hypertension) Categories Of Cholesterol Level
Eating Plan, which includes cutting Total Cholesterol Category
down on salt and sodium and eating Level
healthy foods, such as fruits, veg-
Less than 200 mg/ Desirable
etables, and low-fat dairy products
dL
http://www.womenshealth.gov If lifestyle changes do not lower your 200 - 239 mg/dL Borderline
1-800-994-9662 blood pressure, your doctor may pre- high
TDD: 1-888-220-5446 scribe medicine.
240 mg/dL and High
above
Q: What does high cholesterol have
to do with heart disease? LDL (bad) cholesterol - Lower is
A: Cholesterol is a waxy substance found better. Less than 100 mg/dL is best.
in cells in all parts of the body. When Categories Of LDL Cholesterol Level
there is too much cholesterol in your
blood, cholesterol can build up on the LDL Cholesterol Category
walls of your arteries and cause blood Level
clots. Cholesterol can clog your arteries Less than 100 mg/ Optimal
and keep your heart from getting the dL
blood it needs. This can cause a heart 100-129 mg/dL Near optimal/
attack. above optimal
There are two types of cholesterol: 130-159 mg/dL Borderline
Low-density lipoprotein (LDL) is often high
called the "bad" type of cholesterol 160-189 mg/dL High
because it can clog the arteries that 190 mg/dL and Very high
carry blood to your heart. For LDL, above
lower numbers are better.
High-density lipoprotein (HDL) is HDL (good) cholesterol - Higher
known as "good" cholesterol because is better. More than 60 mg/dL is
it takes the bad cholesterol out of best.
your blood and keeps it from build- Triglyceride levels - Lower is bet-
ing up in your arteries. For HDL, ter. Less than 150mg/dL is best.
higher numbers are better.
All women age 20 and older should Q: How can I lower my cholesterol?
have their blood cholesterol and triglyc- A: You can lower your cholesterol by tak-
eride levels checked at least once every ing these steps:
5 years.
Maintain a healthy weight. If you
page 4 are overweight, losing weight can

U.S. Department of Health and Human Services, Office on Womens Health


Frequently Asked questions

help lower your total cholesterol Therapeutic Lifestyles Changes


and LDL ("bad cholesterol") levels. (TLC) Diet
Calculate your Body Mass Index Get moving. Exercise can help
(BMI) to see if you are at a healthy lower LDL ("bad cholesterol") and
weight. If not, try making small raise HDL ("good cholesterol").
changes like eating an apple instead Exercise at a moderate intensity for
of potato chips, taking the stairs at least 2 hours and 30 minutes each
instead of the elevator, or parking week, or get 1 hour and 15 minutes
farther away from the entrance to of vigorous intensity physical activity
your office, the grocery store, or the each week.
http://www.womenshealth.gov
mall. (But be sure to park in a safe,
well-lit spot.) Take your medicine. If your doc-
1-800-994-9662 tor has prescribed medicine to lower
Eat better. Eat foods low in satu- your cholesterol, take it exactly as
TDD: 1-888-220-5446
rated fats, trans fats, and cholesterol. you have been told to.
Eat more:
Fish, poultry (chicken, turkey-- Q: How do I know if I have heart
breast meat or drumstick is best), disease?
and lean meats (round, sirloin, A: Heart disease often has no symptoms.
tenderloin). Broil, bake, roast, or But, there are some signs to watch for.
poach foods. Remove the fat and Chest or arm pain or discomfort can be
skin before eating. a symptom of heart disease and a warn-
Skim (fat-free) or low-fat (1%) ing sign of a heart attack. Shortness of
milk and cheeses, and low-fat or breath (feeling like you can't get enough
nonfat yogurt air), dizziness, nausea (feeling sick to
Fruits and vegetables (try for 5 a your stomach), abnormal heartbeats,
day) or feeling very tired also are signs. Talk
with your doctor if you're having any of
Cereals, breads, rice, and pasta these symptoms. Tell your doctor that
made from whole grains (such as you are concerned about your heart.
"whole-wheat" or "whole-grain" Your doctor will take a medical history,
bread and pasta, rye bread, brown do a physical exam, and may order tests.
rice, and oatmeal)
Eat less: Q: What are the signs of a heart
Organ meats (liver, kidney, attack?
brains) A: For both women and men, the most
Egg yolks common sign of a heart attack is:

Fats (butter, lard) and oils Pain or discomfort in the center of


the chest. The pain or discomfort
Packaged and processed foods can be mild or strong. It can last
There are two diets that may help lower more than a few minutes, or it can
your cholesterol: go away and come back.

page 5
Heart Healthy Diet

U.S. Department of Health and Human Services, Office on Womens Health


Frequently Asked questions

Other common signs of a heart attack Women are more likely than men to
include: have these other common signs of a
Pain or discomfort in one or both heart attack, particularly shortness of
arms, back, neck, jaw, or stomach breath, nausea or vomiting, and pain in
the back, neck, or jaw. Women are also
Shortness of breath (feeling like you more likely to have less common signs
can't get enough air). The short- of a heart attack, including:
ness of breath often occurs before or
along with the chest pain or discom- Heartburn
fort. Loss of appetite
http://www.womenshealth.gov Nausea (feeling sick to your stom- Feeling tired or weak
ach) or vomiting Coughing
1-800-994-9662
Feeling faint or woozy Heart f lutters
TDD: 1-888-220-5446
Breaking out in a cold sweat

page 6

U.S. Department of Health and Human Services, Office on Womens Health


Frequently Asked questions

Sometimes the signs of a heart attack Q: Should I take a daily aspirin to


happen suddenly, but they can also prevent heart attack?
develop slowly, over hours, days, and A: Aspirin may be helpful for women at
even weeks before a heart attack occurs. high risk, such as women who have
The more heart attack signs that you already had a heart attack. Aspirin
have, the more likely it is that you are can have serious side effects and may
having a heart attack. Also, if you've be harmful when mixed with certain
already had a heart attack, your symp- medicines. If you're thinking about tak-
toms may not be the same for another ing aspirin, talk to your doctor first.
one. Even if you're not sure you're hav- If your doctor thinks aspirin is a good
http://www.womenshealth.gov ing a heart attack, you should still have choice for you, be sure to take it exactly
1-800-994-9662 it checked out. as your doctor tells you to.
TDD: 1-888-220-5446 If you think you, or someone else,
may be having a heart attack, wait Q: Does taking birth control pills
no more than a few minutesfive increase my risk for heart
at mostbefore calling 911. disease?
A: Taking birth control pills is generally
Q: One of my family members had safe for young, healthy women if they
a heart attack. Does that mean do not smoke. But birth control pills
I'll have one too? can pose heart disease risks for some
A: If your dad or brother had a heart women, especially women older than
attack before age 55, or if your mom 35; women with high blood pres-
or sister had one before age 65, you're sure, diabetes, or high cholesterol; and
more likely to develop heart disease. women who smoke. Talk with your
This does not mean you will have a doctor if you have questions about the
heart attack. It means you should take pill.
extra good care of your heart to keep it If you're taking birth control pills,
healthy. watch for signs of trouble, including:
Eye problems such as blurred or
Q: Sometimes my heart beats real- double vision
ly fast and other times it feels Pain in the upper body or arm
like my heart skips a beat. Am I Bad headaches
having a heart attack?
Problems breathing
A: Most people have changes in their
heartbeat from time to time. These Spitting up blood
changes in heartbeat are, for most peo- Swelling or pain in the leg
ple, harmless. As you get older, you're
more likely to have heartbeats that feel Yellowing of the skin or eyes
different. Don't panic if you have a few Breast lumps
f lutters or if your heart races once in a
Unusual (not normal) heavy bleed-
while. If you have f lutters and other
ing from your vagina
symptoms such as dizziness or
page 7 shortness of breath (feeling like you If you have any of these symptoms,
can't get enough air), call 911. call 911.

U.S. Department of Health and Human Services, Office on Womens Health


Frequently Asked questions

Q: Does using the birth control Problems breathing


patch increase my risk for heart Spitting up blood
disease?
Swelling or pain in the leg
A: The patch is generally safe for young,
healthy women. The patch can pose Yellowing of the skin or eyes
heart disease risks for some women, Breast lumps
especially women older than 35;
women with high blood pressure, dia- Unusual (not normal) heavy bleed-
betes, or high cholesterol; and women ing from your vagina
who smoke. If you have any of these symptoms,
http://www.womenshealth.gov
Recent studies show that women who call 911.
1-800-994-9662 use the patch may be exposed to more
TDD: 1-888-220-5446 estrogen than women who use the Q: Does menopausal hormone
birth control pill. Estrogen is the female therapy (MHT) increase a wom-
hormone in birth control pills and the an's risk for heart disease?
patch that keeps you from getting preg-
A: Menopausal hormone therapy (MHT)
nant. Research is underway to see if the
can help with some symptoms of
risk for blood clots is higher in patch
menopause, including hot f lashes, vagi-
users. Blood clots can lead to heart
nal dryness, mood swings, and bone
attack or stroke. Talk with your doctor
loss, but there are risks, too. For some
if you have questions about the patch.
women, taking hormones can increase
If youre using the patch, watch for their chances of having a heart attack or
signs of trouble, including: stroke. If you decide to use hormones,
Eye problems such as blurred or use them at the lowest dose that helps
double vision for the shortest time needed. Talk with
your doctor if you have questions about
Pain in the upper body or arm
MHT. n
Bad headaches

page 8

U.S. Department of Health and Human Services, Office on Womens Health


Frequently Asked questions

For more information


For more information on heart disease, please call womenshealth.gov at 1-800-994-9662
or contact the following organizations:

National Heart, Lung, and Blood Act In Time to Heart Attack Signs
Institute (NHLBI) Campaign
Phone Number(s): (301) 592-8573 National Heart Attack Alert Program
Internet Address: National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov/index.htm (NHLBI)
http://www.womenshealth.gov
Phone Number(s): (301) 592-8573
1-800-994-9662 National Cholesterol Education Internet Address: http://www.nhlbi.nih.
TDD: 1-888-220-5446 Program gov/actintime
National Heart, Lung, and Blood
Institute (NHLBI) The Heart Truth
Internet Address: National Awareness Campaign for Women
http://www.nhlbi.nih.gov/about/ncep about Heart Disease
National Heart, Lung, and Blood Institute
National High Blood Pressure (NHLBI)
Education Program Internet Address: http://www.nhlbi.nih.
National Heart, Lung, and Blood Institute gov/health/hearttruth/index.htm
(NHLBI)
Internet Address: http://www.nhlbi.nih. American Heart Association
gov/about/nhbpep/index.htm Phone Number(s): (800) 242-8721
Internet Address:
http://www.americanheart.org

WomenHeart
Phone Number(s): (202) 728-7199
Internet Address: www.womenheart.org

All material contained in this FAQ is free of copyright restrictions, and may be copied,
reproduced, or duplicated without permission of the Office on Women's Health in the
Department of Health and Human Services. Citation of the source is appreciated.

This FAQ was reviewed by:


Patrice Desvigne-Nickens, M.D.
Program Director
Heart Failure & Arrhythmias Branch
Division of Cardiovascular Diseases
National Heart, Lung, and Blood Institute
page 9
Content last updated February 2, 2009.

U.S. Department of Health and Human Services, Office on Womens Health

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