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

Heart disease is the leading killer of Americans. But it killsmore women than men. The American Heart Association says heartdisease and other cardiovascular disorders kill about five hundredthousand women a year. That is more than the next seven causes ofdeath combined.

In general, women are less likely than men to survive heartattacks. One of the possible explanations has been that women arenot treated as early or as aggressively for heart disease. Mostheart disease research traditionally involved men. But experts arenow discovering that heart disease may act differently in women. TheWashington Post recently reported on these findings.

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

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

Another difference may involve artery spasms. A spasm brieflycauses the artery to narrow. The inner lining, called theendothelium, presses against itself. Doctors have known that womenare more likely to have such spasms. This problem can produce pain.But experts say that in severe cases, it can also produce a heartattack.

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

Researchers are developing ultrasound and other imaging methodsto help discover heart disease earlier in women. Another issue istreatment. The researchers say common drugs and other methods maynot work as well for many women as for men. Heart experts agree thatmuch more research is needed.

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