Heart Disease and Black Women: The Silent Killer that Speaks Volumes

February 2012

One woman dies every minute from heart disease, a little know fact that is overshadowed by other high profile diseases for women. Heart disease, once considered a “man’s disease”, is a cause of great concern for women. It is called a “silent killer” because it often has no symptoms or presents pain that is barely noticeable. The most commonly recognized symptom is persistent chest pain, pressure or other discomfort, called angina. This pain results when the heart is getting too little blood or oxygen. It can be felt under the breastbone and tends to accompany exercise or extreme emotional stress. Women, however, are more likely than men to experience a different type of chest pain which is sharp and temporary.

What is Heart Disease?

Heart disease is a term used to describe a number of problems affecting the heart and the blood vessels of the heart. Coronary artery disease (CAD) is the most common type of heart disease and is the leading cause of heart attacks. CAD occurs when the coronary arteries that surround and supply blood to the heart muscle lose their elasticity and become hardened and narrowed because of plaque build-up inside the artery. This process is called atherosclerosis. As the coronary arteries narrow, blood flow to the heart can slow down or stop, causing chest pain (angina), shortness of breath, heart attack, and other symptoms.

Why is this Important to Black Women?

Black women suffer rates of heart disease that are twice as high as those among white women. Some of the factors that contribute to this disparity include higher rates of overweight and obesity, higher rates of elevated cholesterol levels and high blood pressure and limited awareness of our elevated risks. In addition to having high heart disease rates, Black women die from heart disease more often than all other Americans.

What Black Women Need to Know

Black women are more likely to be overweight or obese, more likely to be physically inactive, and more likely to have high blood pressure and high cholesterol levels – all risk factors for heart disease. Black women also need to know that women often experience heart attack symptoms that are different from those that occur in men. Although chest pain is the symptom most commonly associated with a heart attack, women may have chest pain that is not the most prominent or troubling symptom or may not experience chest pain at all.

Typical heart attack symptoms include:

Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back.
Pain that spreads to the shoulders, neck or arms.
Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.

Women are more likely to experience other, less common warning signs of heart attack including:

Atypical chest pain (pain that is sharp and temporary),
Stomach, back, or arm pain
Nausea or dizziness (without chest pain).
Shortness of breath and difficulty breathing (without chest pain).
Unexplained anxiety, weakness or fatigue.
Palpitations, cold sweat or paleness.

Black women need to be aggressive in seeking attention for heart disease symptoms and concerns by taking the initiative in establishing communications with their doctor: This can improve the chances of receiving appropriate treatment.

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How To Detect A Heart Attack

February 2012

The first hour of a heart attack is known as the "golden hour." If you get help during that first hour, your chances of recovery are greatly improved. Yet many people hesitate to get help when they first experience symptoms. They're afraid of the embarrassment of going to the emergency room and finding that nothing is wrong. So, it is important that you know the symptoms that may indicate that a heart attack is in progress.

Many of the symptoms of heart attack can be brought on by digestive disturbances or other less serious conditions. But only sophisticated medical tests can determine for sure if you're having a heart attack. Heart attacks may vary from person to person, and from heart attack to heart attack. Women, for example, may experience "atypical' symptoms such as pain between the shoulder blades rather than crushing chest pain. This may result in them delaying seeking treatment. That is a great mistake.

Heart attack is one instance where getting treatment promptly can mean the difference between life and death. If you are in doubt, err on the side of being more cautious and go to the emergency room and get yourself checked. We will try to describe some of the most common characteristics of heart attack here. Before that we will introduce the other pain called angina which is often precursor to a heart attack.

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Health conditions common in African-American women:

February 2012

Claudette's story

"I consider myself to be relatively healthy, and I exercise for about 90 minutes every morning. I started having pain in my chest and face when I exercised, so I went to the doctor. I never thought that the pain in my face could be related to my heart, so I was shocked when the tests showed that I had had a heart attack. I thought I was too young to have heart problems. But my father died of a heart attack when he was only 38. My doctor told me that women with a father or brother who got heart disease before age 55 are more likely to develop heart disease. After my second heart attack, I knew that I needed to help get the message out. Women need to know that heart disease is their biggest health threat."
Learn more about the signs of a heart attack from womenshealth.gov.

Heart disease

Heart disease is the number one killer of American women. Heart disease is a group of diseases of the heart and the blood vessel system in the heart. Coronary heart disease, the most common type, affects the blood vessels of the heart. It can cause angina or a heart attack. Angina is a pain in the chest that happens when the heart does not get enough blood. It may feel like a pressing or squeezing pain, often in the chest, but sometimes in the shoulders, arms, neck, jaw, or back. Having angina means you're more likely to have a heart attack. A heart attack happens when a clot mostly or completely blocks blood flow to the heart muscle.

Signs of a heart attack:

Chest discomfort — pressure, squeezing, or pain
Shortness of breath
Discomfort in the upper body — arms, shoulder, neck, back
Nausea, vomiting, dizziness, lightheadedness, sweating
Women can also have less common symptoms, including:

Unusual tiredness
Trouble sleeping
Problems breathing
Indigestion (upset stomach)
Anxiety (feeling uneasy or worried)
If you think you are having a heart attack, you must act quickly to prevent disability or death. Wait no more than a few minutes — five at most — before calling 911.

African-American women are more likely to die from heart disease than women of other races. Diabetes, obesity, high blood pressure, high cholesterol, lack of exercise, and smoking are among the factors that put women at risk for heart disease. Studies have shown that African-Americans don't get the same care for heart disease as whites because they don't get the same tests and treatments. You have the power to fight heart disease! Read on for some tips to keep your heart healthy.

Don't smoke. If you smoke, try to quit. For help along the way, check out our Quitting Smoking section.
Keep a healthy weight.
Make physical activity a habit. Health benefits are gained by doing the following each week:
2 hours and 30 minutes of moderate-intensity aerobic activity
or
1 hour and 15 minutes of vigorous-intensity aerobic activity
or
A combination of moderate and vigorous aerobic activity
and
Muscle-strengthening activities on two or more days of the week
Eat heart-healthy foods. Eat whole-grain foods, vegetables, and fruit. Choose lean meats and low-fat cheese and dairy products. Limit foods that have lots of saturated fat, like butter, whole milk, baked goods, ice cream, fatty meats, and cheese.
Know your numbers. Ask your doctor to check your blood pressure, cholesterol (total, HDL, LDL, and triglycerides) and blood glucose (sugar). Follow your doctor's orders to keep your cholesterol, blood pressure, and blood glucose levels under control.

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High Blood Pressure and African-Americans

February 2012

More than 40 percent of non-Hispanic blacks have high blood pressure. If you're African-American, there's a good chance that you, a relative or an African-American friend has the disease, which is also known as HBP or hypertension. Not only is HBP more severe in blacks than whites, but it also develops earlier in life.

Theories about why blacks are at greater risk

Perhaps higher rates of obesity and diabetes place African-Americans at greater risk for high blood pressure and heart disease. Researchers have also found that there may be a gene that makes African-Americans much more salt sensitive. This trait increases the risk of developing HBP. In people who have this gene, as little as one extra gram (half a teaspoon) of salt could raise blood pressure as much as five millimeters of mercury (mm Hg).

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About Strokes

February 2012

What is a stroke?

A stroke, sometimes called a "brain attack," occurs when blood flow to the brain is interrupted. When a stroke occurs, brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function.

What causes a stroke?

There are two major kinds of stroke.

The first, called an ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel or artery in the brain. About 80 percent of all strokes are ischemic. The second, known as a hemorrhagic stroke, is caused by a blood vessel in the brain that breaks and bleeds into the brain. About 20 percent of strokes are hemorrhagic.

What disabilities can result from a stroke?

Although stroke is a disease of the brain, it can affect the entire body. The effects of a stroke range from mild to severe and can include paralysis, problems with thinking, problems with speaking, and emotional problems. Patients may also experience pain or numbness after a stroke.

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