Heart disease is the No. 1 cause of mortality among men and women in the United States and a major cause of illness, disability and hospitalization. It includes conditions such as coronary artery disease, high blood pressure, heart attack, chest pain, stroke, and congestive heart failure. One in three men and one in ten women will develop a major cardiovascular disease before age 60. The economic costs of cardiovascular diseases are estimated at about $286.5 billion, (American Heart Association, 1999). The direct costs include the cost of hospitalization, physicians, medications, and medical durables while the indirect costs reflect morbidity and mortality.

An estimated 58.8 million Americans have one or more types of cardiovascular diseases. The prevalence of heart disease increases with age. Two in three adults age 65 and older have been diagnosed with heart disease.

Recent surveys indicate that most women are more afraid of breast cancer than heart disease. However, 1 in 2 deaths among women is related to heart disease compared to only 1 in 27 deaths from breast cancer (American Heart Association, 1999). Heart disease causes more deaths among women (more than half a million annually) than the next 16 causes of death combined. Prior to menopause, women are at lower risk for heart disease because of the protective effects of estrogen. The coronary mortality rate increases rapidly after age 65 for women and by age 75 their rate of coronary deaths is equal to that of men. The majority of heart disease than heart attacks in women occur after menopause and the mortality rate associated with a first heart attack is significantly higher in women then in men because it occurs at a later age. The good news is that numerous studies show that estrogen can protect against heart disease. Post-menopausal women who take estrogen may reduce their risk of heart disease by up to 50 percent.

Risk Factors for Cardiovascular Disease

There are several risk factors that affect the chances that you will develop heart disease. While some cannot be changed, many are controllable and can significantly reduce your risk.

What are the risk factors for cardiovascular disease? Click on the link Risk Factors for Heart Disease to visit the American Heart Association (AHA) website. You may want to bookmark the American Heart Association website (http://www.americanheart.org/) as a resource for information on heart disease and stroke.

Risk Factors for Heart Disease
http://216.185.112.5/presenter.jhtml?identifier=4726

Assess your risk for a heart attack or stroke by clicking on the link for the AHA Health Risk Awareness Quiz to take an interactive quiz.

AHA Health Risk Awareness Quiz
http://www.cardassoc.com/risk.html

Homocysteine

Homocysteine is an amino acid which may increase risk for heart disease. Low levels of folic acid can increase levels of homocysteine so a diet rich in folic acid can decrease risk for heart disease. Elevated homocysteine levels may increase risk for heart disease as much as hypertension. Blood homocysteine levels are higher in people with a low dietary intake of folic acid. The Nurses Health Study followed 80,000 nurses for fourteen years and found that those with higher dietary intake of folic acid had a lower risk for heart attack. Individuals with high homocysteine levels often have a high cardiovascular risk profile. Thus, more research is needed before we will know conclusively whether homocysteine is a marker for increased risk or if it plays a causal role in the development cardiovascular disease. To learn more about homocysteine and cardiovascular risk please read the following article.