The woman stood before me, her cardiac risk assessment in hand. She had an alarmingly high cholesterol level, a blood sugar reading in the danger zone, and easily weighed 50 pounds too much. Yet I could see in her eyes that she remained unconvinced of her heart health risks.

After all, she said, she worried more about her husband. Men had heart attacks.

As a physician, I encounter many women who view cardiovascular disease, which includes heart attack and stroke, as a "man's disease." However, this illness does not practice sex discrimination. According to the American Heart Association, in the United States, more women die from coronary disease than all forms of cancer combined.

In fact, one in two women will eventually die of heart disease or stroke and it greatly concerns me that I meet so many women who remain unaware of this troubling fact.

Why is that? I think it begins with a lack of awareness among women and their doctors. A 1997 study by the American Heart Association (AHA) found that only 8 percent of women consider heart disease and stroke as their greatest health threats. Despite this, the AHA reported that 91 percent of women would be comfortable discussing disease prevention and treatment options with their doctors. However, only 30 percent recalled their doctors discussing heart disease and stroke in the past 12 months.

In a 2001 survey conducted by the Society for Women's Health Research/Berlex Laboratories Sex Matters Survey, 76 percent of women surveyed with family histories of heart disease did not know that women have a higher risk of stroke and are more likely to have a stroke within six years of a heart attack than men. While pre-menopause protects women from developing cardiovascular disease as rapidly as men, by 10 years post-menopause, male and female risk is equal.

Yet the Sex Matters Survey found that 56 percent of post-menopausal women did not know that they should take a stress test or have an EKG as part of an annual checkup. Even more concerning, of the women surveyed who knew females may suffer different heart attack symptoms than men, only 17 percent learned this information from their doctor.

As medical director for Anthem's Healthy Woman, a program targeting time-strapped, employed women, I continually talk with working moms who say they are too busy to take care of their preventive health needs. Part of this is because they do not know the significant threat heart disease poses to their health.

Fortunately, many organizations are working to educate women on their risk of developing cardiovascular disease, including the Centers for Disease Control and Prevention (CDC), the American Heart Association, and WomenHeart.

Anthem's Healthy Woman is also doing its part through work-site wellness programs. Along with educational materials, Anthem's Healthy Woman includes free screenings to detect risk factors for heart disease: high blood pressure, high cholesterol, diabetes and emotional stress.

With knowledge comes the power to change. A recent participant in an Anthem's Healthy Woman program wrote, "I was simply afraid to find out what my cholesterol level was, or to be told that I absolutely had to lose weight. Once I had this knowledge, I would be obligated to do something about it. Not knowing made it easier to ignore."

Fortunately this woman did attend our event and followed up with her personal physician. She addressed her risk factors, and today she has shed pounds, reduced her cholesterol to a normal range, and reports that she feels better than she has in years.

Many people, like this woman, fear facing the consequences of unhealthy lifestyle choices. But the good news is that eliminating risks - smoking, obesity, sedentary lifestyle, poor diet, high blood pressure, high cholesterol and diabetes - can earn long-term heart health benefits.

Some simple steps can help prevent heart disease:

• Treat your body to physical movement you enjoy. A recent study in the New England Journal of Medicine stated that daily exercise is the most beneficial step you can take to protect your health
• Breathe clean, smoke-free air. Quitting smoking can cut your risk of heart disease in half.
• Eat a large variety of fresh, colorful food. The AHA recommends five to six servings of fruit and vegetables every day.
• Lose weight if necessary. Studies show that women who gain 22 or more pounds after age 18 are at a much higher risk of heart disease.
• Know your heart-healthy vital signs. Key numbers are blood pressure, blood sugar level, and cholesterol.

American Heart Association

Mayo Clinic: Heart & Blood Vessels Center

National Coalition for Women with Heart Disease

National Heart, Lung and Blood Institute: Live Healthier, Live Longer

Anthem Blue Cross and Blue Shield: Anthem's Healthy Woman and MyHealth@Anthem

Based in Lexington, Ky., she is medical director for Anthem's Healthy Woman, a program of Anthem Blue Cross and Blue Shield, an independent licensee of the Blue Cross and Blue Shield Association.

Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company.
An independent licensee of the Blue Cross and Blue Shield Association.
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