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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.                           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
                                  “Where’s 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

                                               Department                      Services,             omen’s
                                          U.S. Depar tment of Health and Human Ser vices, Office on Women’s 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       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
                                                                               	   •	 Don’t smoke. If you smoke, try to
                                  attack starts. Ideally, treatment should
  TDD: 1-888-220-5446                                                                 quit. If you’re having trouble quit-
                                  start within one hour of the first symp-
                                                                                      ting, there are products and pro-
                                                                                      grams that can help:
                                  If you think you’re having a heart
                                                                                       Nicotine patches and gums
                                  attack, call 911 right away. Tell the
                                  operator your symptoms and that you                    Support groups
                                  think you're having a heart attack.                    Programs to help you stop smok-
                              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 you’re 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
                                                                                      help you make a healthy eating and
                               1. Be physically active                                exercise plan.
                               2. Don’t 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 Women’s 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
                                     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
                                     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 Women’s 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       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
                              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 Women’s 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.
                                     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 Women’s 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   	   •	 Nausea	(feeling	sick	to	your	stom-       	   •	 Feeling	tired	or	weak
                                     ach) or vomiting                         	   •	 Coughing
                              	   •	 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 Women’s 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      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 minutes—five                 increase my risk for heart
                                 at most—before 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 Women’s Health
                                                                    Frequently Asked questions

                              Q: Does using the birth control                  	   •	 Problems	breathing
                                 patch increase my risk for heart              	   •	 Spitting	up	blood
                                                                               	   •	 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,
                                  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 you’re 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 Women’s Health
                                                                 Frequently Asked questions

                              For more information
                              For more information on heart disease, please call 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
                                                                             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
                                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
                              Internet Address: http://www.nhlbi.nih.        American Heart Association
                              gov/about/nhbpep/index.htm                     Phone Number(s): (800) 242-8721
                                                                             Internet Address:

                                                                             Phone Number(s): (202) 728-7199
                                                                             Internet Address:

                                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 Women’s Health

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