The National Heart, Lung and Blood Institute launched a campaign called The Heart Truth to raise women's awareness of their risk for heart disease. The symbol for this campaign is the Red Dress. Everyone can support this campaign by wearing red on National Wear Red Day on the first Friday in February.

QWhat is heart disease?

AThe general term "heart disease" comprises multiple conditions that can affect structures of the heart including heart muscle, heart valves, electrical conduction system of the heart, lining or the sac that houses the heart, as well as blood vessels of the heart also known as coronary arteries. High blood pressure or hypertension is also considered a disease of the heart. About half of all heart disease related deaths are due to coronary arterial disease.

QWhen does a woman's risk of heart disease start to rise?

AThe root of the myth that women are less likely to get heart disease is that coronary arterial disease risk rises after menopause to reach and surpass that of men. Now that men and women are living longer, this is more apparent. Women however, can have heart disease at earlier age as well.

QAre younger women also at risk?

AYes. Additionally, congenital heart disease usually manifests at a younger age when clinically significant. This is true for males and females alike.

QWhat are the risk factors for heart disease?

AThe risks for coronary artery disease are hypertension, diabetes, dyslipidemia, nicotine product use, family history of early onset coronary artery disease and sedentary lifestyle.

QHow does a woman's risk differ from a man?

AThe risks listed above are the same for men and women. For women, the cholesterol profile can evolve to a less desirable state after menopause.

QWhat is the leading cause of death for women?

AHeart disease by far is the leading cause of death in men and women.

QWomen often fear breast cancer more than heart disease. How does that affect their decisions concerning the diagnosis and prevention of heart disease?

AIt is true that women understand the risk and screening process for breast cancer and undergo screening much more readily. This speaks well for the community education programs about breast cancer. Heart disease risk screening and addressing risk factors starts with a visit to the primary care physician. This helps prevent heart disease and especially coronary artery disease. Prevention of heart disease is possible and far more desirable than the alternatives. It is important to take this information to our communities, and have an improved level of understanding as well as acceptance at an individual level for us to be successful in practicing better preventative care.

QAre any ethnic groups at higher risk?

AThere are ethnic and at a more personal level, familial, variations in coronary arterial risk factors that can be screened for and addressed appropriately.

QWhat prevents women from leading a heart health lifestyle?

AWhether it is lack of awareness of the risk factors or more concern for the health and care of those around them, women tend to focus on others more than themselves. A woman who takes better care of herself will be in a position to better care for others. Thus community level education regarding the risk factors and prevention of disease is a powerful tool.

QHow can women lower their risk?

AAppropriate lifestyle, in terms of proper diet and exercise, is of primary importance in addressing the modifiable risk factors of coronary artery disease. Significance of the role of lifestyle modification is highly underrated in the community. Medications are also available to help modify risk factors. Nicotine use is one risk factor that can be completely eliminated and is totally under the power of the nicotine user.

Q Does menopausal hormone therapy affect heart disease?

A Long term study of women and hormone therapy has shown that there is no "protective effect" on development of heart disease with hormone therapy. On the other hand, there is an undesirable effect on colon cancer and dementia. Current guidelines recommend use of perimenopausal hormone replacement therapy for control of perimenopausal symptoms for the shortest duration at the lowest effective dose.

QWhat are the symptoms of a heart attack for women?

AMany of the symptoms of a heart attack are the same for men and women. These symptoms, however, can be varied and are often misunderstood or go unrecognized. This delays the decision to seek help in many instances. Symptoms of chest discomfort with exertion, especially associated with shortness of breath, nausea, profuse sweating, dizziness and loss of consciousness are especially concerning and should be attended to immediately. Often the pain can radiate to the arm, neck, jaw and face with a left-sided predominance. Sometimes symptoms can be similar to "heartburn." Any symptoms that occur on exertion or that are unusual and cannot be explained circumstantially should not be ignored.

Dr. Prasanna Sugathan is a cardiologist with St. Luke's Hospital and Health Network.