Heart Disease the No.1 Killer of Women in the world

Not all women will go the extra mile for additional testing. Research shows that women are less likely to believe they're having a heart attack than men and even less inclined to seek treatment. (The optimum time to get to a hospital is within an hour of the start of the symptoms; the longer you wait, the lower your chances are of survival.)

Many women may also be in the dark about their own personal risk. A heart attack is the first sign of cardiovascular disease - it's often when they learn that they have high blood pressure or cholesterol, or the first time they're confronted with the reality that smoking really did affect their health.

A disease that starts early

Many young women don't realize that even if they don't have any noticeable symptoms now, if they have any risk factors, they may develop heart disease later on.

Smoking, not exercising enough, and eating a lot of the wrong types of fat are all risk factors. A woman in her 30s might think, ‘Even if I've got high cholesterol, there's no need to get it under control yet because I'm still young.' That's not a reason to delay. The moment you have one risk factor, you're already in a higher risk category for heart disease.

The truth is, signs of heart disease may show up years before you start having symptoms. Studies of teenage girls who died in car accidents indicate that they already had a buildup of plaque - the fatty substances and cholesterol that clump in the inner lining of an artery ~ increasing the risk of heart attack.

Unfortunately, doctors aren't always up to speed in detecting heart disease - or even recognizing how much of an epidemic it's become among women. An American Heart Association survey found that less than 20 per cent of doctors (including ob-gyns, primary-care physicians and cardio legists) are aware of the fact that more women die of heart disease each year than men.

Generally, women as a whole are still perceived as a much lower risk group than men. Furthermore, women tend to have more atypical or vague symptoms that make diagnosis more difficult. Sometimes, symptoms in women are thought to be due to anxiety or stress.

For years, medical textbooks were written by men so the bias has been to look at the way diseases affect men more than women. For a long time, it was assumed that the manifestation of diseases, like heart disease, was the same for women as for men. As a result, women were, and still could be, less likely to be referred to a heart specialist because their symptoms may be different from those experienced by men.

Not your dad's heart attack

Part of the problem is that doctors are trained to look for classic signs of a heart attack, such as a pressure or squeezing pain in the centre of the chest that spreads to the neck or shoulder. Though some women will have chest pain or discomfort, it may not be the most prominent symptom.

In a recent study from the University of Arkansas, about 70 per cent of women who have had heart attacks experienced fatigue, almost half had shortness of breath, and nearly 40 per cent had indigestion about a month beforehand. Many of the women in their 30s or 40s who have had heart attacks couldn't walk across a room or down steps without feeling exhausted, but they figured they were just burning the candle at both ends or simply getting older.

Closing the gender gap

Our physiological makeup may explain the differences in symptoms. A National Institutes of Health study in the US that followed more than 900 women over the past decade concluded that women are more likely than men to have micro vascular disease, or blockages of the smaller coronary arteries. As many as 3 million women with heart disease may have this type of blockage.

The gold-standard test for assessing heart disease - the angiogram - is ideal for picking up blockages in the larger coronary arteries (where men are more likely to develop plaque), but it hasn't been very effective in spotting this more diffused type of plaque. And that means that millions of women may not be getting a proper diagnosis.

Hopefully, that will change as research continues to evolve on screening techniques like MRI and CT angiography, which appear to be much more reliable methods to diagnose micro vascular disease in women.

The bottom line? Since heart disease is under diagnosed and under treated in women, it's vital to be your own advocate. That means keeping track of your blood pressure and cholesterol levels, and being able to spot worrying symptoms. Also, adopt a healthy lifestyle - quit smoking or never start the habit, maintain a healthy body exercise regularly. Unfortunately, women are not aware that heart disease is a lifestyle-related disease. Many risk factors like smoking, diabetes, high blood pressure, lack of exercise and stress can be reduced by lifestyle changes.

Indeed, the lifestyle choices you make now can go a long way toward slashing your risk. Research shows that over 80 percent of heart-disease cases in women may be attributed to lifestyle choices like smoking and being sedentary.

There's no magic pill that will help prevent heart disease - it takes time and effort to alter your habit. Unless you want to be an unfortunate statistic, the time to start taking care of your heart health is now

5 life-saving tests every woman

Because the first stages of heart disease are often symptom less, it's essential to start getting screened in your 20s and 30s.

BLOOD PRESSURE

Ideally, your blood pressure should be less than 120/80. A study published in the Journal of the American College of Cardiology found that as blood pressure rises above 115/75, your risk of heart disease increases.

WHEN TO GET IT - If your numbers are normal, your blood pressure should be checked yearly. If it's borderline (120-139/80) or high (over 140/90), you'll need to be rechecked every three months until it's under control.

FASTING BLOOD SUGAR

This test measures the amount of glucose, or sugar, in your blood after an eight-hour fast. A new large-scale study published in The Lancet found that nearly 1.5 million deaths from heart disease and 709,000 from stroke in the US could be attributed to high blood-glucose levels. Ideally, your fasting glucose levels shouldn't be higher than 99 mg/dL.

WHEN TO GET IT - Low-risk women should get a baseline test at age 40. If your numbers are normal, you'll be retested every couple of years: if they're high, they should be checked every six months to a year.

CHOLESTEROL

This is a blood test that measures your levels of HDL (high-density lipoprotein, or "good") cholesterol, your LDL (low-density lipoprotein, or "bad") cholesterol, and triglycerides (another type of fat in the blood associated with HDL, obesity, diabetes, and high blood pressure). High LDL can lead to the buildup of plaque inside your arteries, while HDL helps carry cholesterol from the blood to the liver, where it can be eliminated. Your total cholesterol number should be under 200 -ideally, LDL should be less than 100, HDL more than 50, and triglycerides less than 150.

WHEN TO GET IT - If your numbers are normal, get checked every five years, if they're elevated, check it annually.

C-REACTIVE PROTEIN

This is another blood test to measure levels of C-reactive protein, a marker of inflammation that's been linked to an increased risk of heart disease. One study from Brigham and Women's Hospital in Boston found that elevated levels of C-reactive protein in women predicted their heart attack risk even when their LDL levels indicated low risk.

WHEN TO GET IT - If you have risk factors for heart disease, gets a baseline test around age 30, and repeat it every two to five years.

ELECTROCARDIOGRAM (ECG)

Your heart rate and rhythm are measured by this test.

WHEN TO GET IT - Have a baseline ECG between the ages of 35 and 40. If it's normal, it won't have to be repeated for three to five years.

STRESS TEST

How well your heart handles exertion - an indicator of possible coronary artery disease - is measured by a stress test. Electrodes are attached to your chest and a blood pressure cuff to your arm while you walk or run on a treadmill.

WHEN TO GET IT - If you're easily fatigued during your normal workout, you should get a stress test.

5 habits that may be harming your heart

Even little lifestyle changes can make a big impact when it comes to reducing your risk.

You lack "me" time.

We know that stress plays as important a role in heart disease as a poor diet or not exercising. In fact, a University of Florida study found that mental stress increased the risk of death for heart-disease patients threefold.

Do something that soothes you every day, whether it's 10 minutes of meditation or a long run in the park.

You eat the wrong kinds of fat.

A lot of women are on low-fat diets, so they live on fat-free cookies and cream cheese - foods that pack hefty amounts of calories but little nutritional.

They're better off having a moderate amount of foods rich in monounsaturated fats (found in olive, canola, and peanut oils) and polyunsaturated fats (in fatty fish like salmon, nuts, and flaxseed, sesame, and sunflower oils); these fats may lower cholesterol levels and make them feel more satisfied.

Aim to get up to 30 per cent of your total calories from heart-healthy fats and less than 7 per cent from saturated fat (found in whole-milk dairy products, red meat and butter). Steer clear of trans fats which increase LDL cholesterol and lower HDL.

You think your good lifestyle choices counteract your bad ones.

Sorry, but eating lots of fruits and veggies or being at your target weight can't compensate for not exercising or for smoking. You've got to look at all your risk factors and address each individually.

You skimp on dairy.

A Harvard study found that people who consumed more than three servings of low-fat milk and yogurt a day were 36 per cent less likely to have high blood pressure than those who had less than half a serving.

It appears that low calcium in the diet promotes more calcium in the smooth muscle cells of your arteries, causing them to constrict and raise blood pressure. Popping a supplement isn't as effective, possibly because dairy also contains potassium and magnesium - two minerals that have also been shown to lower blood pressure.

You don't read nutrition labels closely.

Many processed foods have a high-sodium content, so even if it's low-fat, it stills does plenty of damage to your blood vessels.

Don't consume more than 2,300mg of sodium a day. And if you've got high blood glucose, check the carbohydrate levels on the label, too, a product should have less than 20 per cent of the RDA for carbohydrates -and at least 5g of fibre. Finally, look for foods with no partially hydrogenated oils (or trans fats) on the ingredient list (even products with less than 0.5g can still claim "zero grams of trans fat" on their label).

30 minutes to a Healthy Heart

Strengthen the most important muscle in your body

Working out to improve your health just doesn't have the same appeal as exercising for slimmer thighs or a firmer butt. Research shows that exercising for only 30minutes on most days may reduce your risk of heart disease by nearly 40 per cent.

Regular exercise strengthens your heart and lungs, improves circulation and raise good cholesterol levels. Plus, it helps you maintain a healthy weight, which helps prevent high blood pressure and diabetes, risk factor for heart disease.

Choose any cardio activity - walking, jogging, biking or machine trainer. Workout three or five times a week in addition to strength training