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Are You at Risk for a Heart Attack?

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Some 400,000 women will die from heart disease this year. FITNESS investigates why young women are at risk -- and reveals the symptoms and screenings you need to know about now.

The New Face of Heart Disease

Heart disease has a brand-new face. It's young, mostly fit, and definitely female. The problem is that women -- and many doctors -- are only beginning to recognize it. Last November, paging through the Journal of the American College of Cardiology, Jooyoung Julia Shin, MD, an attending cardiologist at Montefiore Medical School in New York City, read in a report that heart-disease deaths in women under 45 inched up 1.3 percent each year between 1997 and 2002. So, deaths in women under 45 are increasing by the thousands every year, while cardiac mortality is dropping in all other segments of our population. "I was shocked," Dr. Shin recalls. "I mean, I'm female, I'm in the demographic -- and I'm a doctor! I had no idea. It was a wake-up call to me as a doctor and a woman."

Why is this happening? Historically, the typical cardiac patient has been male and middle-aged or older -- that, say experts, is at the heart of the female heart problem. Although awareness campaigns for breast cancer, which kills 1 in 35 women, abound, relatively few organizations educate young women about heart disease, which kills 1 in 3. "The fact is, most support networks just don't target people like me," says Robin Levy, 35, who had her third open-heart surgery in 2007 and now wears a pacemaker. In the past, females were left out of heart-disease research studies, which may have led to a perception that it's not a problem for women, says Lori Mosca, MD, PhD, director of prevention cardiology at New York-Presbyterian Hospital in New York City and a FITNESS advisory board member. Indeed, recent research shows that among people who have relatives with heart disease, young women in particular are more likely to smoke and be overweight -- two big risk factors -- than individuals without a family history of the disease. And while 21 percent of men with a family history are sedentary, that number rises to 40 percent in women, despite the proven cardiovascular benefits of exercise.

Just as young women seem to be in the dark about preventing heart problems, they often don't realize it when they do have one. Female-oriented conditions such as microvascular disease (a stiffening of the smaller blood vessels, often affecting otherwise healthy premenopausal women) and pregnancy-related heart trouble are less understood than coronary-artery disease, the buildup of fatty deposits that triggers most attacks in men. Meanwhile, 4 in 10 women don't recognize heart disease's most dramatic, life-threatening sign: an attack.

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