Womens Health & Fitness

Below are the top causes of death for women in the United States, starting with the most common. Take this opportunity to learn about each health concern and how you can reduce your risks. What you learn may surprise you.

Surprised? Many women are. It's common to think breast cancer is the No. 1 threat to women's health when, in fact, heart disease is responsible for more deaths in women than all forms of cancer combined. Heart disease is the most significant health concern for women in the United States today, responsible for nearly 489,000 deaths each year.

The common belief that heart disease affects mostly men is a dangerous myth. In reality, more women than men die of heart disease in the United States each year. But according to the American Heart Association, only 13 percent of women know that heart disease is a major threat to their health.

Avoid smoking and limit the amount of alcohol you drink.
Eat a diet rich in fruits, vegetables and whole-grain products.
Exercise regularly.
Control other health conditions that may put a strain on your heart, such as high blood pressure, diabetes and high cholesterol.
If you're at increased risk of heart disease, your doctor also may suggest a daily low dose of aspirin.

It's easy to believe cancer is a major threat to women's health, but the kinds of cancer women are dying of might surprise you. According to the American Cancer Society (ACS), the most common cause of cancer death in U.S. women is lung cancer. It's estimated that more than 73,000 women in the United States will die of lung cancer in 2005, with 90 percent of these deaths linked to cigarette smoking.

Breast cancer is the second-leading cause of cancer death in U.S. women, and it's estimated that more than 211,000 women will be diagnosed with breast cancer in 2005. The ACS estimates that about 40,000 women die each year of breast cancer.

The third-leading cause of cancer death for women in the United States is colorectal cancer. Like heart disease, colorectal cancer is often mistakenly thought of as a man's disease, but as many women die of colorectal cancer each year. Estimates suggest that it claims the lives of approximately 28,000 women in the United States annually.

Don't smoke or chew tobacco.
Exercise regularly.
Eat a healthy diet.
Avoid excessive sun exposure.
Limit the amount of alcohol you drink.
Have regular preventive health screenings.
Know your family medical history and review it with your doctor.

Nearly 163,000 people in the United States die of stroke each year, and almost two-thirds of them are women. Stroke not only is women's No. 3 killer, but it also is one of the leading causes of disability in America.

Smoking and uncontrolled high blood pressure are important risk factors for stroke. Although stroke is highly preventable, certain risk factors such as family history, age, sex and race cannot be controlled. Even if you're at increased risk of stroke, you can still take steps to prevent it:

Women’s Health Study Finds Vitamin E Does not Protect Women from Heart Attack, Stroke, or Cancer Vitamin E supplements do not protect healthy women against heart attacks and stroke, according to new results from the Women’s Health Study, a long-term clinical trial of the effect of vitamin E and aspirin on both the prevention of cardiovascular disease and of cancer.

The vitamin E results of the Women’s Health Study are published in the July 6 issue of the Journal of the American Medical Association. In addition to the cardiovascular disease findings, the study authors report that there was no effect of vitamin E on total cancer or on the most common cancers in women — breast, lung, and colon cancers. The Women’s Health Study was funded by the National Heart, Lung, and Blood Institute (NHLBI) and the National Cancer Institute of the National Institutes of Health.

“This landmark trial has given women and their physicians important health information. We can now say that despite their initial promise, vitamin E supplements do not prevent heart attack and stroke. Instead, women should focus on well proven means of heart disease prevention, including leading a healthy lifestyle and controlling risk factors such as high blood pressure and high cholesterol,” said NHLBI Director Elizabeth G. Nabel, M.D.

The Women’s Health Study was conducted between 1992 and 2004. The participants were 39,876 healthy women age 45 years and older who were randomly assigned to receive 600 IU of Vitamin E or placebo and low-dose aspirin or placebo on alternate days. The participants were followed for an average of 10.1 years. The aspirin results published last March found no benefit of aspirin (100 mg every other day) in preventing first heart attacks or death from cardiovascular causes in women but did find a reduced risk of stroke overall, as well as reduced risk of both stroke and heart attack in women aged 65 and older.

In recent years, there has been a great deal of public and scientific interest in the potential of antioxidant vitamins like vitamin E to reduce the risk of cardiovascular disease. Laboratory and animal research suggested that vitamin E might prevent the accumulation of fatty deposits inside arteries, which would reduce the chance of clogged and blocked arteries. Other large observational studies have also suggested that people who eat foods high in vitamin E or take supplements have a lower risk of coronary heart disease. Although several clinical trials conducted prior to the Women’s Health study found little cardiovascular benefit from vitamin E, these trials were shorter and primarily studied individuals with cardiovascular disease or CVD risk factors. The intent of the Women’s Health Study was to provide a long-term look at the effects of vitamin E supplementation among healthy women.

Participants in the Women’s Health Study were monitored for major cardiovascular “events” — a combination of nonfatal heart attack, nonfatal stroke, or cardiovascular death. By the end of the study, participants in the vitamin E group had 482 such events compared to 517 in the placebo group. However, this difference was not statistically different.

Non fatal heart attacks: 184 in the vitamin E group versus 181 in the placebo group — not a statistically significant difference.
Non fatal strokes: 220 in the vitamin E group versus 222 in the placebo group — not statistically significant.
Study investigators also found no significant effect of vitamin E on total deaths (deaths from all causes). By the end of the study, there were 636 deaths in the vitamin E group compared to 615 in the placebo group.

Although total deaths were unaffected by vitamin E, there was a significant 24 percent reduction in cardiovascular deaths among all women taking the vitamin (106 deaths in the vitamin E group versus 140 in the placebo group). In another positive finding, women 65 and older taking vitamin E had a 26 percent decrease in heart attacks and cardiovascular deaths, but not strokes.

“These intriguing findings deserve further study. But they were not part of the primary aim of the study — to look at the effect of vitamin E on overall cardiovascular disease, which includes heart attack, stroke, and cardiovascular death. Additionally, previous studies of vitamin E in patients with heart disease have not shown any benefit for cardiovascular deaths. At present, we cannot recommend vitamin E for prevention against cardiovascular disease or cancer,” said lead investigator I-Min Lee, MBBS, ScD of Brigham and Women’s Hospital.

The study finding of a decrease in major cardiovascular events among women age 65 years and older is relatively unique, added Dr. Lee. “Almost all previous trials have not reported findings by age. If other current trials provide age-related results, these additional data will help clarify the Women’s Health Study results of benefit among the women aged 65 years and older,” she said.

Overall, the results were not affected by a study participant’s menopausal status, use of hormone therapy, body mass index, alcohol intake, or physical activity. The study found no significant side effects among women taking vitamin E except for an increase in nosebleeds, which was likely due to chance, as there was no increase in risk of other types of bleeding, including hemorrhagic stroke.

According to the 1999-2000 National Health and Nutrition Examination Survey, an estimated 13.5 percent of women in the U.S. take vitamin E supplements, although it is not known how many are taking the vitamin to prevent heart disease and stroke.

NHLBI’s Dr. Nabel encouraged women to learn more about proven ways to prevent heart disease, the number one killer of women. The Heart Truth (www.hearttruth.gov), NHLBI’s program to increase women’s awareness of the dangers of heart disease, offers resources and information on leading a healthy lifestyle.