Coronary artery disease (CAD) is the leading killer of women in the United States. Yearly, women exceed men in the number of deaths due to CAD, with the total number of deaths exceeding the next seven causes of death in women combined. Despite these alarming statistics, many women are still unaware of the risk CAD poses. In a recent survey of women completed by the American Heart Association, only 13 percent considered heart disease their greatest risk, and fewer than half considered themselves well informed about heart disease.

Coronary artery disease occurs when the arteries feeding the heart muscle become blocked. When this happens, the victim is at high risk of a heart attack. The most effective way to combat CAD is to treat risk factors. A medical history of hypertension, high cholesterol, smoking, adult-onset diabetes mellitus, or a family history of premature coronary artery disease increase a woman’s risk of developing CAD. Unfortunately, many women do not even know they carry these risk factors.

Coronary arteries supply oxygen and nutrient-rich blood to the heart. Coronary artery disease occurs when plaques (patches of fatty substances and calcium) build up on the inner lining of coronary arteries. These plaques can gradually thicken and narrow the coronary arteries, decreasing the oxygen and nutrient supply to the heart. If a clot suddenly develops at a plaque site, all blood flow may stop. This narrowing and clotting increases a woman’s risk for heart attack and sudden death.

High blood pressure and cholesterol, smoking, adult-onset diabetes, chronic kidney disease, a sedentary lifestyle, and a family history of premature CAD all increase a person’s odds of getting CAD. In women, the risk presented by diabetes is greater than in men. (Diabetes increases a woman’s risk for CAD by three to seven times; in men, it’s two to three times.) Hormone-replacement therapy for menopausal women, once thought to lower the risk of CAD, is now thought to increase that risk. For this reason, women already at risk of CAD should avoid this treatment.

This condition can be diagnosed through a clinical evaluation with a physician. Some of the tests used to aid diagnosis include an electrocardiogram (ECG), echocardiogram, and blood laboratory studies. If your physician wants to know how your heart works while you exercise, you may have a cardiac stress test. Other tests include coronary angiography, which shows how blood flows through the coronary arteries. If blockages are identified, the number, location, and size of any blockages can be incorporated into a treatment plan.

Coronary artery disease (CAD) is more prevalent in men than in women but is more deadly in women than in men. Following a heart attack, the rate of death in the first year for women (about 38 percent) exceeds that of men (about 25 percent). For unknown reasons, the CAD mortality rate in women has consistently exceeded men since 1984, with the disparity increasing on a yearly basis. This is why prevention of CAD in women, by treating risk factors early, is extremely important.

Addressing risk factors can greatly reduce the chance of suffering from CAD. Women at risk should exercise regularly, stop smoking, eat a low-fat diet, and work with their doctor to control their diabetes and blood pressure.