Nancy’s back hurt, but she didn’t feel like going to the doctor. Besides, she reasoned, he’ll only tell her that her blood pressure was a little high and that she needed to lose weight. She didn’t know her rationalization might cost Nancy her life.

Heart disease is the number one killer of women in this country. Yet, heart attacks appear differently in women than men. As a result, more women die from heart attacks because they seek help later, if at all, said Dr. Robin Germany, a cardiologist with OU Physicians and an assistant professor of medicine at the University of Oklahoma Health Sciences Center.

“Most women worry about breast cancer, but more women die from heart attacks,” Germany said, noting that one in 26 women will die from breast cancer while one in every two women will die from heart disease.

“And women suffering heart attacks present differently. They get pain in their jaw or back and stomach nausea. They may just get short of breath or be tired,” she added. “Very few get the traditional chest pain with the pain radiating down the left arm.”

Because the early warning signs of heart trouble may be missed or written off as something else in women, care is often delayed. “If women could get to the emergency room faster, we could go a long way towards saving their heart tissue,” she said.

In addition to not recognizing the symptoms, Germany pointed out that women’s outcomes from heart attacks and heart disease are often far worse than men. She pointed out while the death rate from cardiovascular disease in men is dropping, it is increasing in women.

“We, women, get our heart attacks about 10 years later than men,” she explained. “Pre-menopause, we are somewhat protected. Then, about age 65, we begin to catch up with the men in terms of heart attacks and surpass them in terms of death from heart attacks.”

Compounding these issues is the fact that women are just physically smaller than men.

“Women are smaller, so our blood vessels are smaller. They only make stents (for angioplasty) so small, and they are often too large for women,” Germany explained. “That is why angioplasties don’t always work in women and why women have a much more difficult time with bypass surgery.”

Germany said in some instances heart problems and early warning signs may be missed due to other health issues. When women have multiple health issues, such as diabetes, kidney problems or bleeding problems, diagnosing heart disease can be more difficult.

“Women’s symptoms can be so vague that it is easy to be written off,” Germany said. “And women try to explain it away so they set themselves up to being written off. In addition, some older physicians were taught that women don’t get coronary disease, so they don’t think their patient could have a heart problem.

One area that Germany cautions about is blood pressure. She said that many women live for many years with slightly high blood pressure, then are surprised when they are diagnosed with heart damage.

“Blood pressure being slightly high for years causes a lot of damage,” she said. “And women should not think about blood pressure being high or low for them – they should know what normal blood pressure is and do the things they need to do in terms of diet and exercise to get their blood pressure to normal.”

According to Germany, too many women too often neglect their own physical care and focus on that of their husbands and families instead. They may realize something is not quite right, but don’t want “to be a bother” to anyone.

She said women need to take steps to protect their health. A good start is to find ways to be more active every day. Germany called exercise a “God-made bypass” because it can help clear the cardiovascular system.

Germany stressed if women would learn to listen to their own bodies and take as good a care of themselves as they do of their families, they could help eliminate cardiovascular disease and potentially add another ten years to their lives.

“It is odd, women tend to take men’s health very seriously, but they are typically not as aggressive about their own health. Fortunately, they are getting somewhat better.”

What Women Should Know About Heart Disease

According to OU Physicians’ Dr. Robin Germany, every woman should be aware of these important facts about her own heart health:

• Know her cholesterol level and have a physician explain what it means.
• Have her blood pressure checked regularly and learn how to maintain normal blood pressure.
• Discuss the relationship between estrogen and heart disease with her doctor.
• Know how weight and diet contribute to heart disease.
• Try to be active every day. 30 minutes of moderate exercise at least three times a week is a minimum. (Always talk to your doctor before beginning a new exercise program especially if you have serious health problems.)
• Talk to her doctor and pharmacist about her medications. Certain medications can react differently in women than in men.
• Take steps keep diabetes in check.
• Quit smoking. A woman reduces her risk of heart attack the moment she does.