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For Women, If Your Doctor Doesn’t Bring Up Heart Disease Risk, You Should

Though heart disease is the number-one killer of both men and women in the U.S., women are often not aware of their risk. One reason for this may be that heart disease presents different symptoms in women, symptoms less widely recognized by women and their doctors, says Dr. Kevin Campbell, a cardiologist based in Raleigh, North Carolina, author of Women and Cardiovascular Disease: Addressing Disparities in Care.

Women can learn to identify their risk factors, Campbell told Sound Medicine in a recent interview (full interview below), and work with their doctors to develop a prevention or treatment plan. "It’s all about interpreting atypical symptoms in the setting of risk,” he says, “and about starting a conversation with your doctor.” Here are four simple steps to owning your heart disease risk.

1. Know your risk.

Heart disease risk factors are the same for both genders: high blood pressure, diabetes, smoking or tobacco abuse, obesity, high cholesterol. Having a family history can increase your risk. If you know your blood cholesterol and blood pressure levels you can calculate your ten-year risk of heart disease using the NIH’s online tool. (Yes, men can use it too). The number you’ll get is called a “Framingham Score.”

2. Monitor your symptoms

If you’re a woman and you know you’re at risk, keep an eye on health problems that may at first seem like symptoms of something else. For instance, angina, a common symptom of coronary heart disease, can show up for women as pain in the neck, jaw, throat and upper abdomen. Like men, women also experience chest pain, but while men usually describe it as squeezing or pressure, women are more likely to feel a burning sensation.  For women symptoms of the early stages of heart disease may include fatigue, anxiety, feelings of dread and unease. “They feel like they have the flu,” Dr. Campbell says. “That may be the first presentation of heart disease.” For more details of symptoms to be aware of, visitthe National Institutes of Health heart disease page.

3. Find a doctor who listens, and start the conversation

Since heart disease symptoms in women look so much like symptoms of other illnesses, doctors often miss them altogether, Carroll says. So it’s often important for women to start the conversation with their doctors. If your Framingham Score is high or you have other risk factors, and you experience symptoms, show your score to your doctor and tell him or her about any family history. Dr. Carroll recommends having this conversation with a primary care physician, but he says an increasing number of OB/GYNs are also trained and equipped with screening tools for heart disease.

4. Make lifestyle changes, even small ones

Healthy lifestyle can minimize risk. In a recent interview with health psychologist Bonnie Spring, we learned that even small changes made midlife – like getting more aerobic exercise, limiting alcohol, and eating more vegetables - can reduce risk of heart disease. You can find Spring’s tips here.