How does your gender and heritage affect your risk?

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How ethnicity plays a role: African-American women are at greater risk for cardiovascular disease than any other ethnic group. | FILE PHOTO

Did You Know?

Heart disease and stroke are the leading causes of death for Hispanics.

The rate of high blood pressure for non-Hispanic black females age 20 and older is 46.6 percent.

The exercise stress test, or stress ECG, may be less accurate in women. For example, in young women with a low likelihood of coronary heart disease, an exercise stress test may give a false positive result. In contrast, single-vessel heart disease, which is more common in women than in men, may not be picked up on a routine exercise stress test.

The American Heart Association

While many people face some risk of cardiovascular disease at different points in their lives, some are more at risk due to their gender, family history or heritage. So it’s a good idea to keep these factors in mind when you discuss your heart health with your doctor. Each one is a vitally important part of what makes you “you.”

Women vs. men

Cardiovascular disease is the No. 1 killer of women of all ethnic backgrounds. But less than half of women realize it.

Women’s health risk may be due to gender difference and gender bias. Factors that may explain the apparent disparity in treatment of men and women include:

• In the past, many of the major cardiovascular research studies were conducted on men. Results of clinical studies under way may help clarify gender differences that may affect diagnosis and treatment of women with heart disease.

• Clinicians and patients often attribute chest pains in women to non-cardiac causes, leading to misinterpretation of their condition.

• The most common warning sign of a heart attack in both men and women is chest discomfort — most heart attacks involve discomfort in the center of the chest that last more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Women, however, are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

• Women may avoid or delay seeking medical care, perhaps out of denial or not being aware of both typical and atypical heart attack symptoms.

• Since women tend to have heart attacks later in life than men do, they often have other diseases (such as arthritis or osteoporosis) that can mask heart attack symptoms. Increased age and the more advanced stage of coronary heart disease in women can affect treatment options available to physicians. Increased age also can help explain women’s greater mortality after heart attacks.

• Some diagnostic tests and procedures may not be as accurate in women, so physicians may avoid using them. That means the disease process resulting in a heart attack or stroke may not be detected in women until later, with more serious consequences.

• The exercise stress test, or stress ECG, may be less accurate in women. For example, in young women with a low likelihood of coronary heart disease, an exercise stress test may give a false positive result. In contrast, single-vessel heart disease, which is more common in women than in men, may not be picked up on a routine exercise stress test.

• More precise noninvasive and less invasive diagnostic tests tend to cost more. These include thallium, sestamibi or echocardiographic stress tests.

Hispanic women

• Mexican-American women are at greater risk of cardiovascular disease due to higher rates of obesity, diabetes and metabolic syndrome than Caucasian women. In addition, women whose main language is Spanish have the highest prevalence of physical inactivity.

• Unfortunately, Hispanic women are less likely than Caucasian women to know that these things increase their heart disease risk. Only one-third of Hispanic women consider themselves well-informed about heart disease, compared to more than 40 percent of Caucasian women.

• Heart disease and stroke are the leading causes of death for Hispanics.

• High blood pressure is a leading cause of heart disease and stroke. The prevalence of high blood pressure for Mexican women over 20 years old is 28.7 percent.

• Stroke is the No. 3 cause of death for Hispanic women, behind heart disease and cancer. It’s also a leading cause of serious, long-term disability.

African-American women

• African-American women are at greater risk for cardiovascular disease than any other ethnic group, yet they are less likely than Caucasian women to know that they may have major risk factors.

• Diabetes, smoking, high blood pressure, high blood cholesterol, physical inactivity, overweight/obesity and family history of heart disease are all greatly prevalent among African-Americans and are major risk factors for cardiovascular disease, including stroke. Fewer than half of African-American women (41 percent) consider themselves well informed about cardiovascular disease.

• African-Americans are at greater risk for heart disease, stroke and other cardiovascular diseases (CVD) than Caucasians. The prevalence of CVD in non-Hispanic black females is 49 percent, compared to 35 percent in non-Hispanic Caucasian females.

• High blood pressure is a leading cause of stroke. The rate of high blood pressure for non-Hispanic black females age 20 and older is 46.6 percent.

• The risk of heart disease and stroke increases with physical inactivity. Physical inactivity is more prevalent in women, African-Americans and Hispanics. For non-Hispanic black females age 18 and older, 33.9 percent are inactive, compared to 21.6 percent of non-Hispanic white females.

Sources: Heart Disease and Stroke Statistics - 2006 and 2008 Updates; Survey conducted August 2003.

— The American Heart Association