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This is Gwen Outen with the VOA Special English Health Report.

Heart disease is the leading killer of Americans. But it kills more women than men. The American Heart Association says heart disease and other cardiovascular disorders kill about five hundred thousand women a year. That is more than the next seven causes of death combined.

In general, women are less likely than men to survive heart attacks. One of the possible explanations has been that women are not treated as early or as aggressively for heart disease. Most heart disease research traditionally involved men. But experts are now discovering that heart disease may act differently in women. The Washington Post recently reported on these findings.

Men often develop one main blockage in major arteries. Arteries carry blood away from the heart. Women also develop blockages in major arteries. But experts say women are more likely to have smaller buildups of plaque along the length of the artery. These smaller areas of fatty material can be easily missed. But expert say they can be just as dangerous as one big blockage.

We talked to Doctor Noel Bairey Merz, a heart expert at Cedars-Sinai Medical Center in Los Angeles. She says that unlike in men, heart disease in women is often found in the smaller arteries which are often overlooked.

Another difference may involve artery spasms. A spasm briefly causes the artery to narrow. The inner lining, called the endothelium, presses against itself. Doctors have known that women are more likely to have such spasms. This problem can produce pain. But experts say that in severe cases, it can also produce a heart attack.

Heart experts say cardiovascular disease is often preventable. High cholesterol, high blood pressure, smoking and being overweight can all cause different forms of heart disease. But researchers say the lining of arteries may also weaken as levels of estrogen decrease in older women. That hormone helps process nitric oxide, which helps arteries work better.

Researchers are developing ultrasound and other imaging methods to help discover heart disease earlier in women. Another issue is treatment. The researchers say common drugs and other methods may not work as well for many women as for men. Heart experts agree that much more research is needed.

This VOA Special English Health Report was written by Cynthia Kirk. This is Gwen Outen.