Friday, February 05, 1999
High risk of heart disease for local women
Survey puts it at 27 percent
BY TIM BONFIELD
The Cincinnati Enquirer
More than 49,000 Tristate women face a “very high risk” of developing heart disease in their lifetimes and another 143,000 have a “high risk,” according to a survey released Thursday.
Those figures add up to 27 percent of the women in Greater Cincinnati, about twice as many as doctors had predicted before the survey was conducted.
The survey, conducted for the Health Alliance of Greater Cincinnati, involved random telephone calls to more than 850 women in an eight-county region. It ranked women according to their answers to questions about 14 known risk factors, such as cigarette smoking, obesity, stress levels and family history of heart disease.
The biggest surprise in the survey was “the sheer size of the numbers,” said cardiologist Dr. Lynne Wagoner. “We were astonished. We expected to see 10 to 15 percent in the high-risk categories.”
Women facing the highest heart disease risks include the elderly, African-Americans, widows and divorcees, the poor and the less-educated. More women living in outlying, more rural counties also faced higher heart disease risks than those living in Hamilton County.
The Health Alliance has directly contacted survey respondents who appeared at high or very high risk to urge them to see a doctor. For other women, officials hope the survey will raise awareness of an often overlooked health risk.
“We think we die of breast cancer and other cancers, but we don't consider that we might have a heart attack,” said Marcia Swehla, director of the Alliance Women's Health program.
The survey is a more scientific follow-up to the Health Alliance's “Women's Heart Quiz” project, which started on Valentine's Day 1997. That project got 4,902 responses to thousands of questionnaires sent through local health events and direct mail.
The quiz rates an individual's heart disease risk by assigning points to questions about known risk factors. The numbers of high-risk women found through the mail-in questionnaires surprised doctors.
Concerned that those results were skewed by “self-selection,” such as women responding because they know they have heart problems, the Health Alliance hired the University of Cincinnati Institute for Policy Research to do a random telephone survey.
“This is another way to raise women's awareness of their potential for heart disease,” said Dr. Amy Frankowski, an internist with Alliance Primary Care. “I've had several women come in after they did this survey to ask, "What can I do to change these results?'”
While women cannot change their genetic risks, several often-preached lifestyle changes can make a difference. “Number one: Quit smoking,” Dr. Frankowski said.
Women also should exercise more, eat less fat and more fiber, and know their blood pressure and cholesterol statistics. Postmenopausal women can reduce heart disease risks with hormone replacement therapy. For serious cases, medications can help control blood pressure and cholesterol, Dr. Frankowski said.
Heart disease is the No. 1 killer of women. Past studies have shown that women tend to have lower survival rates after heart attacks and cardiac treatments than men. Experts suspect that's because women wait longer to seek help and when they do, many doctors brush off their concerns.
“Ten years ago, women coming in with vague chest discomfort were dismissed as not being at risk,” Dr. Wagoner said.
However, doctors are learning that women with serious heart problems may never feel the crushing chest pain that men often feel. Instead, they may feel pain in their neck or jaw, numbness in an arm, have trouble breathing or suddenly feel hot and uncomfortable, Dr. Frankowski said.
Cindy Maiorano, a 42-year-old Cheviot resident, was surprised to find herself in the “very high risk” category. Her father had a massive heart attack in his 30s, she was eating too much high-fat food, had high cholesterol and a high amount of stress.
“I thought I was doing everything I was supposed to do. I do walk and watch what I eat,” she said.
Since taking the test in 1997, she has added more fruits and vegetables to her diet, which has helped reduce her cholesterol. More important, she knows her risks now and makes a point of staying in regular contact with her doctor.
The Health Alliance plans to launch programs aimed directly at African-Americans, widows and other high-risk groups. Meanwhile, the Health Alliance will provide free information to those who request it.
FOR INFORMATION
For heart disease information or if you are a woman who wants to take a heart quiz, call the Health Alliance, (888) 640-CARE. The alliance will hold a women's health symposium at 7 p.m. Feb. 17 at Christ Hospital.
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