Health risk management a matter of knowledge


April 19, 1994|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Medical Tribune News Service

A recent Gallup survey revealed a startling lack of knowledge on the part of American women about what the real risks were to their health.

More than 80 percent of the women surveyed did not know that heart disease is the No. 1 cause of death for women.

Less than 1 percent of the women surveyed identified stroke as another major threat, even though it is the third leading cause of death among women.

Overall, the women thought the greatest risk to their health was the one posed by breast, cervical and ovarian cancers.

While this is a well-deserved testament to the effectiveness of breast cancer activists, it also indicates women need to become much more aware of the greatest risks to their health.

Women need to be aware of cancer, but they must also ask themselves: "What else do I need to know and what should I ask my doctor?" To answer these questions, I turned to Trudy Bush, professor of epidemiology at the Johns Hopkins School of Hygiene and Public Health, who was called upon to interpret the data from the Gallup poll.

Q: Why aren't women more aware that heart disease is their No. 1 health risk?

A: Until about four years ago, when the National Institutes of Health set up the Office for Women's Health Research in response to enormous pressure from women in Congress led by Sen. Barbara Mikulski, D-Md., women weren't even included in clinical trials to study heart disease.

Heart disease was perceived as a man's disease, and we are still fighting that perception today.

The sad truth is that heart disease is way out in front in terms of being the No. 1 cause of death among females.

Heart disease kills more than 365,000 women every year. Breast cancer claims less than 50,000 lives.

Q: Do these statistics mean I'm in danger of a major heart attack?

A: No. Women are less prone than men to get the kind of heart attack where a man is fine one day and collapses the next.

In women, we often see angina (chest pain caused by lack of oxygen to the heart) and then a gradual decline in heart function.

Heart disease and stroke are major cripplers of women. Two-thirds of the women who get heart disease are disabled.

The good news is that early prevention works. Late prevention also has effects and is better than doing nothing at all.

Q: What other diseases are life-threatening to women?

A: Lung, breast and colon cancers are the three major cancer-killers in women. They rank higher than both ovarian and uterine cancer.

At her yearly exam, every woman should ask her doctor's advice about being screened for colon cancer.

Q: What can I do to lower the risk of heart disease?

A: The good news is that heart disease is more preventable than breast cancer. Women need to be able to recognize the risks and then act on that knowledge.

The risk factors include smoking, low levels of "good" HDL cholesterol, diabetes, lack of physical activity and excess weight.

You can see that, for the majority of these factors, women have control of the health of their hearts.

Dr. Genevieve Matanoski is a physician and epidemiologist at the Johns Hopkins School of Hygiene and Public Health. She is a founding director of the school's Institute for Women's Health Research and Policy.

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