Awareness that heart disease is the leading killer of women was nearly twice as high amongwhite women (55 percent) as among African-American (30 percent) and Hispanic (27 percent) women. Minority women face the highest risk of dying from CVD.

Only 30 percent of women spontaneously listed heart disease as women’s leading cause of death, found the American Heart Association’s first national survey in 1997, a figure that increased to 34 percent in the 2000 survey. However, in 2003, that figure jumped to 46 percent, a significant improvement.

Although women have a good general knowledge of CVD risk factors, they often do not knowtheir own risks. For instance, when asked whether a specific activity could reduce the risk of getting heart disease, 90 to 100 percent of respondents recognized that exercise, losing weight, quitting smoking, avoiding dietary cholesterol and reducing salt intake are useful lifestyle changes.

A problem, some 70 percent did not know their own levels of low-density lipoprotein (LDL) and high-density lipoprotein (HDL), two components of total cholesterol.

Women’s understanding of heart disease was high across racial and ethnic groups in several areas. When asked as a true-false question, 95 percent of women overall knew that heart disease develops gradually over many years and can easily go undetected. Ninety-seven percent of white women, 91 percent of African-American women, and 91 percent of Hispanic women answered this question correctly.

Yet fewer than half of all women, 40 percent, consider themselves very well informed or well informed about heart disease, a figure that is unchanged since 2000. Those aged 25-34 were least likely to report feeling very well/well informed (27 percent) and most likely to report feeling "not at all informed" (22 percent).

Some practical heart disease actions for wellness managers:

Women may not have classic heart attack symptoms. In women, a heart attack may reveal itself through nausea, vomiting, tightness in the chest or shortness of breath — signs that could be misinterpreted as indigestion.

(Men are generally more likely to experience pain localized just to the left of the breastbone or in the entire upper chest. Others have pain to the left shoulder and inside the left arm to the waist; a common combination is pain in the mid-chest, neck and jaw.)

Many warning signs associated with chest pain are similar for men and women, such as fatigue, pain at rest, shortness of breath and weakness. Dizziness is the next most common symptom reported by women, whereas men report arm pain.

When a women's chest pain is related to her heart, the pain tends to be more vague than the type of chest pain men experience; back pain also is twice as common for women as for men.

Women: Heed These First Signs of a Heart Attack

• Arm or shoulder pain; jaw, neck or throat pain; toothache; pain in the back, beneath the breastbone, or in the pit of the stomach.
• Back pain — it's twice as common for women as for male patients.
• Vague chest pains that come and go but fail to improve with rest.
• Loss of appetite and shortness of breath at night, which are significantly more common among women than among men.
• Combinations of these symptoms — heart attacks seldom strike different people in exactly the same way.

For more information, visit the American Heart Association's Web site at www.amhrt.org.