For women, warning signs are different, but health needs the same

Something wasn't quite right.

Linda DeSmet was gaining weight. She couldn't figure out why.

Then she started getting short of breath with the slightest bit of exertion.

"If I walked a short distance, I had a hard time breathing," recalls DeSmet, of Grosse Pointe Woods, Mich.

She knew she needed to see a doctor, but she put it off. Then, one evening, her sister insisted she get checked out. It's a good thing she did.

"I was having congestive heart failure," says DeSmet, an administrative assistant for the tech company HP in Detroit.

She ended up in the hospital for back-to-back heart surgeries in 2009 - the first to replace a defective aortic valve; the second to install a pacemaker.

Two years later, DeSmet is a healthy and active 60-year-old with a message for other women: "Take care of yourself. If you suspect something is wrong, check it out. We always blow it off, like I did. But we have to start putting ourselves first. We can't take care of anyone if we're in poor health."

DeSmet doesn't just talk the talk. She exercises daily at Women's Only Workout in St. Clair Shores, Mich., and she sticks to a diet rich in fresh fruits and vegetables and low in salt and sugar.

There are big reasons women should be concerned, according to the American Heart Association. Among them:

• Heart disease is the No. 1 killer of women ages 20 and above.
• Heart disease kills more women than the next five most common causes of death of among women combined - including all forms of cancer.
• One in three women dies of heart disease, compared with one in 30 from breast cancer.
• Ninety percent of women have one or more risk factors for developing heart disease.

But here's the good news: Women can take steps to prevent heart disease, and more research is focusing on women.

A study published in the Feb. 7 issue of the Journal of the American College of Cardiology shows that therapy using statin drugs - cholesterol-lowering medication - can be just as effective in treating women at increased risk for heart disease as it is in treating men.

This is significant because until now, the effectiveness of statin therapy for women has been questioned, says Claire Duvernoy, founder of the Women's Heart Program at the University of Michigan Health System.

"This analysis confirms that statins are another important weapon in the battle against heart disease in women," says Duvernoy. "It combines the results of 18 prior studies."

But doctors point out that the most significant steps toward reducing heart disease risk are those that women can and should take on their own.

"It's mostly common sense," Duvernoy says. "Know your numbers. Know your blood pressure. Know your body mass index. Know your blood sugar. Know your cholesterol. Know your family history. Work with your doctor to get those numbers into an acceptable range.

"And it's especially important for women to stop smoking. Smoking seems to have a more detrimental impact on women's arteries than men's arteries."

Women also should be aware that signs of heart problems differ for men and women.

"Men are more likely to experience the classic chest pains and sweating like you see in the movies. On the contrary, women are more likely to feel pressure or heaviness in the chest or even in the back or shortness of breath," says Lalitha Rudraiah, a cardiologist at Henry Ford Macomb Hospitals.

One of her main messages is that women need to know the seriousness of heart disease, and they have to begin to take care of themselves.

"Women downplay the symptoms. They put off getting checked. They think, 'Oh, I'm just feeling tired.' Or 'I'll check it out later.' "

"I had a patient recently who started feeling chest pressure at 3 a.m. and she decided she had to wait until morning so she could drop her son off at school first, and then she came to the hospital."

Fortunately, doctors were able to treat her blocked artery, but it could have been much more serious, she says.

Rudraiah points out that a 2003 study of 520 women shows that almost 80 percent of those who had a heart attack reported having at least one symptom - fatigue, sleep disturbances, shortness of breath, indigestion and anxiety - for more than one month before their heart attack.

Women must learn to distinguish between what's normal and what's not, doctors advise.