Despite the attention we pay to cancer as a health problem, heart disease is the leading cause of death in women in the United States, killing more than 250,000 each year. This is more than all cancers combined.
Between the ages of 45 and 64, one in nine women will have some form of heart disease, but for those over 65, the figure jumps to one in three.
Why does the risk of heart disease increase so dramatically for women over 65?
Heart disease increases with age, but in women hormone levels that drop after menopause may also contribute to an increased risk of heart disease. This proposition is now being tested in a major national study called the Heart and Estrogen-Progestin Replacement Study (HERS). Johns Hopkins is participating in the study.
What is the purpose of the HERS study?
A: The study looks at women who have a history of heart disease to see whether women who receive hormone replacement therapy have fewer second heart attacks and heart attack deaths than those women who do not receive hormones.
Who will benefit from this study?
The study is especially important to the 50 million women who have been through menopause. The study may be particularly important to women who already have heart disease or who are at high risk of developing heart disease, as it will increase our understanding of the relationship between hormones and heart disease in women.
Can I be involved in the study?
Yes. If you are post-menopausal and between the ages of 55 and 75, have diagnosed coronary artery disease and have not had a hysterectomy, you can volunteer to participate.
What does the study involve?
A:A: The study will run for five years and involves three visits a year to the study center in Lutherville. Once a year each participant receives a thorough physical exam. This includes a pelvic exam, a pap smear, a mammogram and an EKG. In addition, three cholesterol tests are done over the five-year span of the study. All these tests and procedures are free.
Will I have to take any medication?
Yes. The women participating in the HERS study are divided into two groups. One group will receive the hormones estrogen and progestin, both of which are commonly used for the treatment of menopausal symptoms, and one group will receive a sugar pill.
Why should I participate in the HERS study?
Not only will you be receiving an annual physical exam, including a mammogram, each year at no cost, you will also be helping in the national effort to increase our knowledge of how to reduce the risk of heart disease -- the No. 1 cause of death in American women.
Is there anything else I can do to keep my heart healthy?
Many factors have been shown to be related to heart disease in women, including hypertension and smoking. Lack of exercise is also a risk factor. To keep your heart healthy, eat a healthy diet, exercise regularly and don't smoke.
How does a woman know if she has heart disease?
Classic symptoms include shortness of breath and chest pain. Many women are misinformed about their health, and their heart disease is often not diagnosed until it is well advanced. If you think you may have heart disease, be assertive with your physician and get a thorough checkup. Remember, if you have chest pains or shortness of breath it isn't necessarily indigestion. It might be a warning your heart is in trouble.
For more information about the HERS study, call Alice McKenzie, (410) 825-1841.
Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Hygiene and Public Health.