Heart disease is the world's leading cause of death. Yet most cases can be prevented.
Doctors say reducing deaths from heart disease will require not only changes in the way people live. It will also require changes in public policy, and better public knowledge about differences in heart disease between men and women.
Two conditions, coronary artery disease and microvascular disease, can both reduce blood flow to the heart. Experts at Brigham and Women's Hospital in Boston say heart disease in women is more likely to be caused by microvascular disease.
Finding this condition may require tests other than an angiogram. An angiogram is a kind of X-ray test. Doctors use it to look for a buildup of fatty plaque material that can block arteries. Arteries carry oxygen-rich blood away from the heart to the rest of the body.
The World Health Organization says heart disease kills eighteen million women a year. And these are not just older women. Carrie Vincent had a heart attack after giving birth to her first child.
CARRIE VINCENT: "My God, I was thirty-one years old. Thirty-one-year-olds don't have heart attack."
Ms. Vincent is now taking her message to women in their homes through an organization called Sister to Sister.
Irene Pollin started Sister to Sister to educate women about heart disease. Ms. Pollin urges women to learn about their blood pressure, cholesterol levels and other risk factors for heart disease.
IRENE POLLIN: "The goal is really prevention, having people understand their risk, that they should really get screened, know their numbers and then do something about it."
Ms. Pollin teamed up with a heart specialist at Brigham and Women's Hospital. Dr. Joanne Foody works mostly on prevention efforts.
JOANNE FOODY: "The good news is we know that ninety percent of heart disease is preventable by reducing risk."
Reducing risk means not smoking. It means controlling or avoiding diabetes. It also means keeping a healthy weight and eating healthy foods. And it means exercising at least thirty minutes on most days and managing or reducing stress.
Dr. Dariush Mozaffarian at the Harvard School of Public Health also has other advice about reducing the risk of heart attacks. He says people should eat more fish, whole grains, vegetables, vegetable oils and nuts, and reduce the amount of salt and trans fats in their diets. Trans fats can increase the risk of heart disease.
Heart disease increasingly affects women in developing countries. Dr. Mozaffarian places a lot of blame on the global epidemic of obesity.
DARIUSH MOZAFFARIAN: "People are getting chronic diseases not from eating too much, but eating poorly. And so in fact what they're not eating is actually probably mostly what's harming them."