Questions & Answers

Maria T. Vivaldi, M.D.
Corrigan Women’s Heart Health Program
Massachusetts General Hospital
Heart Center
1. Why are women of color at higher risk for developing heart disease?

Women of color have an increased incidence of high blood pressure, obesity and metabolic syndrome, all of which are related to heart disease. For each risk factor you have, your risk of developing heart disease DOUBLES!

2. Are the symptoms of a heart attack different for a woman?

Women can experience different symptoms that may lead to a heart attack, such as indigestion, neck or jaw pain, shortness of breath and in the elderly, fatigue. If you have a new symptom, you need to be proactive and be evaluated by your doctor immediately.

3. Is heart disease preventable?

Absolutely! In fact, 90 percent of all heart attacks are caused by risk factors that you can directly change or control. Start by knowing your numbers, including your weight, blood pressure, cholesterol, blood sugar and then if necessary, get help to work to improve those numbers. If you smoke, STOP, and try to participate in some exercise daily. Lastly, be aware of your family history for heart disease which increases your personal risk as well.

4. Why is smoking harmful to the heart and blood vessels?

Cigarettes, cigars and pipe tobacco have a number of bad effects. All three contain nicotine which increases your heart rate and blood pressure. Nicotine also causes narrowing of the blood vessels in your body (particularly the tiny blood vessels in your heart). The carbon monoxide in tobacco “replaces” oxygen in our blood, which is the fuel our hearts need to do its work. Smoking also increases the risk of blood clots forming in our blood vessels. These changes caused by smoking can lead to blockages in the blood vessels and result in a heart attack or a stroke.

5. What is the link between diabetes and heart disease?

Diabetes is a strong risk factor for heart disease. In fact, 50 percent of people with diabetes will develop heart disease. Therefore, diabetes is one of the most important risks for heart disease and you need to do all you can to control your diabetes, which includes watching what you eat, exercising, controlling your weight, taking your diabetes medications and monitoring your blood sugar.

6. How much physical activity and exercise is recommended to help prevent heart disease?

The American Heart Association recommends a minimum of 30 minutes of moderate-intensity exercise, such as walking or biking, on most days of the week and 60-90 minutes if you need to lose weight. The more exercise you get, the more your heart will benefit!

7. Is there a relationship between hormones such as estrogen and heart disease?

In the past, it was felt that since hormones, such as estrogen, protect women against heart disease, women were advised to take hormones in pill form when they reached menopause when the levels of these hormones decrease. However, studies have recently shown that these “replacement” hormones actually have the opposite effect and increase the incidence of heart attacks, stroke and blood clots in the lungs. Now, the recommendation to take these replacement hormones is reserved for women who experience severe symptoms of menopause, and further, it is recommended that these hormones be taken only for the shortest possible time and in the lowest combination or dose.

8. Should women take an aspirin a day?

The recommendations for daily aspirin use by women and men are a bit different. Studies have shown that aspirin is helpful to protect men against heart attacks and should be taken daily beginning at age 35. For women though the studies led to different recommendations for the use of aspirin. The recommendation for daily aspirin in women is only for women who develop heart disease or for those women who are at very high risk for heart disease such as women with diabetes. A daily aspirin is also recommended for all women age 65 or older who have diabetes.

9. Why are plant-based foods like fruits and vegetables recommended to improve health?

A number of studies have shown that if you increase your daily intake of fruit and vegetables from five to eight servings a day, you reduce chances of having a cardiac event. Also, for people with a family history for heart disease, increasing fruit and vegetable intake lowers the risk of developing heart disease to the same risk level as people without a genetic link or family history! In fact just two additional servings per day can decrease your risk of having a heart attack by 4 percent. So your mother was right about eating those fruits and vegetables!