Understanding Heart Disease

Heart disease, cardiovascular disease, heart attack … the terms can be confusing and scary. Learn to recognize signs of heart disease and how to know when you're at risk.

Your Health

woman making the shape of a heart with her handsHeart Disease 101: What is CVD?


Cardiovascular diseases (CVD) are diseases of the heart and blood vessels. These diseases are frequently referred to simply as heart disease and stroke.

CVD or heart disease and blood vessel problems usually develop over a period of years. They can begin when cells, cholesterol and fat build up inside the walls of blood vessels that supply the heart or brain narrowing them.

Heart attack and stroke are common results of conditions that restrict or stop the blood flow to the heart or brain. At any given age, men have a greater risk of heart attack than women, but women are only half as likely as men to survive a heart attack, and more likely to have a second attack.

Warning Signs of a Heart Attack

Heart disease can cause heart attacks. Heart attack symptoms may not be sudden or dramatic like in the movies, so don't wait until symptoms are severe or unbearable. If you or someone you know is having one or more of the following symptoms, dial 9-1-1 or the emergency number in your neighborhood.

  • discomfort that spreads from the chest to the shoulders, neck and arms
  • pressure or squeezing pain in the chest that may spread into the neck, shoulders and arms
  • nausea, breathlessness, sweating or fainting with pain in the arms, chest or neck
  • feelings of impending doom
  • significant fatigue
  • problems sleeping
  • indigestion
  • weakness in the arms

Remember, not all heart attacks begin with sudden, crushing chest pain, especially for women, for whom heart attack symptoms often are milder and less specific. Women may complain of unusual fatigue, sleep problems, indigestion and weakness in their arms in the month before a heart attack.

C-Reactive Protein & Heart Disease Risk: What's It Mean

Maybe you've heard something about C-reactive protein and your risk for developing heart disease. Here's what we know: The blood level of a protein called C-reactive protein (CRP), a marker for inflammation, may be as important a risk indicator for heart disease as cholesterol levels. Numerous studies support a strong link between high levels of CRP and heart disease, regardless of other risk factors. In fact, CRP levels appear to be a better indicator of heart attack, angina and other cardiovascular problems than LDL cholesterol levels. Studies also find that reducing CRP levels reduces the risk of heart disease, and that cholesterol-lowering drugs called statins offer an excellent way to reduce CRP levels.

So why don't we use CRP as a marker for heart disease risk instead of cholesterol? Because we still don't know how often levels should be measured or how to evaluate the findings. For instance, even though the U.S. Centers for Disease Control and the American Heart Association define levels below 1 mg/L as low risk and those between 1 and 3 as average risk, there is some evidence that levels above 1 mg/L still carry an increased risk of heart disease.

In addition, because CRP is a marker of inflammation, it may also signal other diseases besides heart disease, such as obesity, complications of diabetes, and colon cancer. Therefore, whether it’s elevated due to heart disease or another condition can be tough to tease out.

Plus, there are also differences in baseline levels based on race and gender. For instance, women tend to have higher baseline levels of CRP than men. Studies also find women on oral hormone therapy have CRP levels significantly higher than those of nonusers, regardless of other risk factors. Some of this may be related to the type of hormone therapy used, the dosage and the delivery method (there is no increase in women using hormone patches). Until we understand how all this plays out in terms of overall risk and how effective reducing CRP levels is on heart disease and deaths, it's unlikely that any national guidelines will recommend using CRP to screen for heart disease as they do with cholesterol.

If you have questions about C-reactive protein and inflammation and your risk for heart disease, ask your health care professional for more information.

5 Facts about Women & Heart Disease

  1. More women die from heart attacks than men.
  2. When estrogen levels start to drop at menopause, a woman starts to lose the protective effects of this hormone, and her risk for heart disease rises.
  3. The blood level of a protein called C-reactive protein (CRP), a marker for inflammation, may be as important a risk indicator for heart disease as cholesterol levels.
  4. Statins can reduce the risk of heart attack and stroke even in people with relatively low levels of cholesterol.
  5. Smoking continues to be the single most preventable risk factor for heart disease for both women and men.
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