Women and heart disease: It's in your DNA

Think breast cancer is the top health threat facing women? Statistics Canada says three out of every ten women die of heart disease, making it the leading cause of death. And your risk of developing it is doubled if you've got heart disease in your family history. Which is why the Heart and Stroke Foundation is making that genetic component a big part of its holiday awareness campaign.

Catchy statistics emphasize how important it is for Canadian women to find out if they have a family history of heart disease. The foundation also has true stories including a woman who paid little attention to her family history of heart attacks until she had a major one herself at the age of 40.  

A new Heart and Stroke Foundation poll found that half of Canadians report that they know a family member with heart disease; despite that, a third have not visited a doctor and to discuss how that inherited risk could affect them. There's also a powerful new video that shows a man having a heart attack on a subway.  As paramedics try to save him, he ages in reverse like Brad Pitt in The Curious Case of Benjamin Button and turns into a child who is destined genetically to have heart disease. The public service ad has a happy ending: knowing his genetic risk averts a heart attack later in life.

Scientists have identified roughly 20 percent of all genes involved in heart disease and stroke, and hope to map out the remaining 80 per cent in the next five to 10 years. They believe that they're on the cusp of treatments that can be targeted at people with a family history.  

But you don't have to wait for a genetic cure. Having a strong family history doubles your risk of a heart attack or stroke but you can reduce that risk substantially by doing things like exercising, watching your cholesterol and your blood sugar. The foundation has also developed a Heart and Stroke Risk Assessment, and is asking all Canadians to take the free of charge test - men and women alike.

The gap between what women know and what they need to know is pretty big. That's according to a US survey by the Women's Heart Alliance and presented this week at the American Heart Association's Scientific Sessions. In the US, as in Canada, heart disease and stroke is the number one killer of women. Yet only 27 percent of women surveyed could name another woman they know with heart disease, and only 11 percent could name a woman who has died from heart disease.  

There are several reasons why women aren't as aware of their risk as they should be. First, women are protected early in life through,the female hormone estrogen - at least until they reach menopause. Men who don't enjoy the same benefit begin having heart attacks in their 40s and 50s in much greater numbers.That fact alone reinforces the false notion that heart attacks don't happen to women. Second, as the main care providers for kids and aging parents, some women don't report the symptoms of a heart attack because they feel they can't abandon their duties.  

Doctors too play a role in the denial of heart disease risk among women. The US survey I talked about found that health care providers often focus on blood pressure and cholesterol in men; in women they focus mainly on weight leading some women to put off going to the doctor until they've dropped a few kilos.

There's a lot at stake if women don't take steps to reduce the risk. Over the past 25 years, rates of heart attack and stroke have dropped steadily in men; in women, rates have fallen at a much slower rate. Compared to men, the health system does fewer tests on women and offers them fewer options for treatment. Unless women make this a personal health issues, the discrepancy will continue.  

And down the road, we'll see more and more older women being diagnosed with chronic heart failure diagnosed at the end of life because women, their family members and their health care providers failed to connect the dots.