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America's Top Killer Knows No Gender Lines

© Gretchen Malik

For years, heart disease was considered a "man's" disease. But post-menopausal women are just as likely to develop heart disease as men, and more likely to die of stroke. Unfortunately, many remain unaware of the extent of their potential risk.

In a recent survey by the American Heart Association, sixty-three percent of women names breast cancer as their greatest health threat--nine times as many as those citing heart disease. (Seven percent cited heart disease and one percent cited stroke.) In reality, however, half of all American women will die of heart disease or stroke, which claim 500,000 female lives each year in the U.S., more than from the next eight causes of death for women combined. By comparison, breast cancer kills about 44,000 American women each year.

Who Is To Blame?

The big question is why the message of heart disease risk hasn't reached more women. We know that physicians and the media offer less information on heart disease to women. Less than one-third of the women surveyed said their doctor never discussed heart disease with them during a general health discussion.

Even if the information is offered, the common misperception that heart disease is a "man's problem" may lead many women to ignore what they hear. Another myth is that heart disease is a "good" way to die--suddendly and without the long suffering of cancer. Many women also erroneously think that stroke only affect the elderly.

But chances are you'll be hearing a lot more about heart disease in the future, as the "baby boom" women head towards menopause, when hormonal changes and lifestyle factors come together to increase the risk of heart disease dramatically.

The Hormone Connection

Before menopause, circulating hormones such as estrogen are at their highest, and thought to be the reason why women have a much lower risk of heart disease and stoke than men do. This has led scientists to believe that estrogen somehow protects women's arteries, but more research need to be done to determine exactly how estrogen exerts its beneficial effects. We do know, however, that as levels of estrogen begin to drop off, the risk of heart disease and stroke in women increases until eventually it equals that of men.

When women take estrogen after menopause, their risk decreases to about half that of women who don't take hormones. Hormone replacement therapy (HRT) lowers LDL ("bad cholesterol"), raises HDL ("good cholesterol"), and helps keep blood vessels relaxed--all of which may help prevent heart disease.

All women who are approaching menopause should discuss HRT with their doctors. Since there are potential side

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