February, the month most known for chocolate hearts, is a good time for women to pay attention to their own heart health.

Coinciding with the American Heart Association's American Heart Health Month, cardiologist Dr. James Ryan spoke with women Thursday at HealthPlace in Hermitage about their risks for heart disease.

Ryan said heart disease often goes undiagnosed in women, and that many women may consider heart disease as a "man's disease." In reality, more women die of heart disease than of breast cancer every year.

"Women tend to complain less, and they seem to be the ones taking care of their husbands, the house, kids ..." Ryan said.

Symptoms of heart disease are also different in woman than in men, which is why women may fail to realize they have it.

"In women you can be fooled, because their symptoms can be different than men," Ryan said.

Men usually experience angina, a crushing pain to the chest, but women may experience pain in the neck, jaw or even cheek; nausea; vomiting; dizziness or weakness.

Heart disease is also harder to diagnose in women. Women are more likely to have false-positive or non-diagnostic stress tests. In nuclear stress tests or stress echocardiograms, breast tissue can create shadows that can look like blockages or hide blockages.

Women generally have heart attacks 10 years later in life -- in their late 60s or 70s -- than men do and have more "silent" heart attacks. Their chances of re-occurring heart attacks and dying in the hospital are higher than men's, but risk of sudden death from heart attacks is greater for men than it is for women, Ryan said.

Ryan said he is not sure why women have a greater chance of having another heart attack than men do, but the size of their hearts and arteries may play a role.

When dealing with heart disease, prevention is key.

"Fifty percent of people who have heart attacks don't make it to the hospital," Ryan said. "You have to catch it early. You have to be aggressive about risk factors."

Risk factors for heart disease include smoking, hypertension, diabetes and obesity.

Quitting smoking, lowering cholesterol levels and getting plenty of exercise can all lower risk of heart disease.

Ryan noted that switching to a low-fat diet can be a complete lifestyle change.

"It's easy to say, but hard to do," he said when referring to diet and exercise.

Ryan suggested sticking to the diet all month and then "pigging out" one night a month on a favorite dessert or at a favorite restaurant -- provided the diet starts again the next day.

"A big cheat once a month is better for your arteries than one little cheat every day," he said.

As for exercise, Ryan recommended walking.

"Be a moving target. Get out there and walk," he said. He suggested starting out slow -- 10 minutes a day, three times a week -- and then working up to walking 30 minutes a day, three times a week.

"Everyone can afford it, it's not difficult to do. Even in bad weather you can walk in the mall," Ryan said. "If you get into a good walking program now ... your chance of dying of a heart attack goes down. You will live longer."

Medications such as aspirin, beta blockers and ACE inhibitors also decrease the risk of heart disease.

Ryan also said that studies have shown hormone replacement therapy does not protect women's hearts, even though post-menopausal women are at a higher risk for heart disease. He said anyone currently on hormone replacement therapy should continue, but women not currently on it should not start for the purpose of preventing heart disease.

You can e-mail Herald Staff Writer Erin Remai at eremai@sharon-herald.com