Bryant Stamford

Special to Courier Journal

Until recently, heart disease was considered a man’s disease. One of the reasons is that men tend to have heart attacks at a younger age, and the younger you are the more attention it gets.

In addition, women are much more concerned about breast cancer, believing it’s their major risk for a fatal disease. Breast cancer is, of course, a major problem, especially in younger women.

But when women hit their 50s, heart disease claims more lives, and by age 75, death from heart disease is eight times more likely than breast cancer.

Because heart disease was believed to be a man’s disease, men were the primary focus of research and little attention was paid to heart disease in women.

It was assumed that the established risk factors of smoking, high blood pressure, high serum cholesterol, lack of exercise, etc. applied equally to men and women, and this is largely true.

However, we now know the symptoms that signal a problem may be different, as well as the triggering event, and therefore, if a woman expects to have the same experience as a man, she may misinterpret what is going on.

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TRIGGERS AND SYMPTOMS

For men, a heart attack is likely to be triggered during exertion, things like lifting and carrying, climbing stairs, cutting the grass, etc.

The triggering event in women is more likely to be stress than exertion. Therefore, if a woman is not exerting herself, she may ignore signals that something is wrong.

For men, the key symptom that something is wrong is sharp, burning pain and tightness in the chest. There also can be nausea, dizziness, difficulty breathing or pain in the upper body, neck or jaw.

Women differ from men and severe chest pain is less likely. Instead, there may be unusual upper body discomfort, difficulty breathing, extreme fatigue, or nausea. Symptoms in women are more easily dismissed, which can delay medical intervention.

This is a big problem because during a heart attack immediate medical attention is critical to outcomes and survival.

The underlying cause of a heart attack is similar for men and women. In both cases, the problem is cutting off blood flow and oxygen supply to the heart muscle. But, there also is an important difference here as well.

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In men, there is likely to be problems with blockage in the larger coronary arteries that impede blood flow to the heart muscle. Detecting blood flow problems in men is much easier because the blockage in larger arteries is more obvious and easier to measure.

In women, the problem of reduced oxygen supply is more likely to occur in small vessels. Damage to the inner walls of small vessels can cause spasms that squeeze the vessels closed, stopping blood flow. This is more difficult to determine, which means even with sophisticated testing, problems in women can be overlooked.

STROKE

As with heart disease, men and women differ in some ways when it comes to stroke. Again, men tend to have strokes at a younger age, but overall, more women have strokes because they live longer. Men and women experience common symptoms for strokes.

There may be sudden weakness or numbness in the face or a limb on one side of the body. Trouble speaking or understanding speech and severe headache can occur.

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Along with symptoms common for both men and women, women may have “other” symptoms, including hiccups, extreme fatigue, nausea, racing heart rate, sudden pain in the face, arm or leg. Unfortunately, these other symptoms often are ignored because they don’t fit the typical pattern we assume will occur.

A big item that also differs between men and women is that women are the caretakers. When a man has a problem, the women in his life make sure he gets immediate attention.

Women, on the other hand, are less likely to speak up about feeling bad and no one notices. This can waste valuable time.

For heart attack, you have about two hours before heart tissue begins to die. For stroke, tissue plasminogen activator (tPA) must be administered within three hours to dissolve blood clots that may be blocking blood flow to the brain.

As to whether or not you are really having a heart attack or stroke, get to the hospital quickly and don’t worry about being wrong.

THE BOTTOM LINE

Heart disease and stroke are equal opportunity destroyers of health, impacting men and women alike. Know the triggers and symptoms specific to each gender and act on them immediately.

As always, prevention is the best strategy, and keeping your blood pressure down pays big dividends.

For every 10 point drop in systolic blood pressure, you reduce your risk of heart disease and stroke by more than 30 percent. So, get busy exercising, eating right and losing weight.

Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at stamford@hanover.edu.