Bermuda?s death rate from heart disease and coronary conditions is even worse than the US, according to figures from the Pan American Health Organisation.

For women especially the statistics are staggering. Heart disease is the number one killer of women on the Island with on average four woman every month suffering a heart attack.

Smoking, poor diet, stress and lack of exercise are amongst the biggest contributory factors to the growing problem which has led to some women in their early 40s suffering cardiac arrests.

Getting the message out and helping women make better choices is the aim of a series of presentations on the Island which started yesterday to coincide with February being designated Heart Disease Awareness Month.

The launch was made at the offices of PartnerRe, in Hamilton, by Cardiac Care Nurse Myrian Balitian-Dill in conjunction with the Bermuda Heart Foundation.

By the end of the session, the reinsurance company staff who had listened to the facts and heard about the health consequences were only too willing to tag on a free pedometer to help them measure how much walking exercise they are getting each day.

For predominately office-bound staff the target of 10,000 steps ? or roughly two hours of walking ? is a challenge, but avoiding becoming part of the frighteningly high occurrence of heart disease in Bermuda is all the incentive Ms Balitian-Dill, of King Edward VII Memorial Hospital, hopes her audiences will need.

Heart disease is prevalent in most countries around the world. The US has one of the highest mortality rates with 204 deaths per 100,000 population, but that is lower than Bermuda where the death rate is a fraction over 222 per 100,000.

What makes things worse for women, especially those from a non-white background, is that most of the diagnosis and treatments relating to heart disease have come from studies of white males.

While some symptoms are the same, in women they can often be different and this has led to many cases of women and doctors simply not recognising the warning signs until it is too late.

Women in Bermuda can be misdiagnosed or may even fail to seek treatment because they do not believe they are at risk.

As a result the death rate for women with heart disease has seen little or no improvement during the past 20 years.

Increasing awareness that heart disease is the number one killer of women on the Island is the aim of the Bermuda Heart Foundation?s Women and Heart Disease campaign.

?The aim is to inform women of their number one killer, empower them on what can be done to lower their risks and to encourage physical activity,? said Ms Balitian-Dill.

The combination of less awareness amongst women and health professionals about heart disease in women and the under-representation of women and non-white ethnic groups in previous research, is believed to be a contributory factor in the higher mortality rates for women who suffer heart attacks in hospital and the fact that women over 50 who suffer a heart attack are twice as likely to die as a man who suffers the same.

On almost every count women with heart disease have a greater risk of dying from a heart attack than a man. But, unlike men, women are also less likely to suffer a sudden and fatal cardiac arrest because they have a more gradual onset of symptoms.

Beyond the ?classic? symptoms of shortness of breath, sweating, chest discomfort and pain radiating down an arm, women can also experience unusual fatigue, back and jaw pain and gastric symptoms.

Ms Balitian-Dill urged women to know their numbers ? their blood pressure, blood sugar and cholesterol levels ? and to ask their doctors to carry out the checks and give them the information, not just a ?you?re fine?.

They should ensure they eat healthy fats, such as Omega-3 fatty acids found in fish or walnuts. If they have meat with a meal it should be no larger than the palm of their hand and the thickness of a finger, starchy food portions such as rice or potatoes should be no more than the size of a fist and vegetables should fill two hands.

She also encouraged women to know their body mass index, something that can be calculated from a chart of height and weight at a doctor?s clinic or on the Internet, and to have a waist measurement of no more than 35 inches (40 inches for men).

All those who attended the presentation were given a pedometer to measure the amount of walking they do each day ? the goal is to average 10,000 steps ? and to engage in some physical activity, eat fruit and vegetables regularly and limit alcohol to a moderate level.

Others who are interested in being involved should contact the Bermuda Heart Foundation on 239-2052.

This Friday is Wear Red for Women Day, when everyone is encouraged to wear red to support the women?s heart disease awareness message.

And every Wednesday this month between 12 noon and 2 p.m. there is blood sugar and blood pressure screening at the KEMH.