Heart disease is the No.1 disease killer of American women, but much more needs to be done to ensure their treatment is on par with that of men’s, top experts say.

Consider these statistics:

• In the first year after a heart attack, women are over 50 percent more likely to die than men.
• In the first six years after a heart attack, women are almost twice as likely to have a second heart attack.
• Women age 45 and younger are more likely than men to die within a year of their first heart attack.

There are many reasons for this situation, from a lack of awareness to inequality in the medical system, they say.

“The problem of women and heart disease has been highlighted for the past 20 years but people still think that heart attacks only happen to men,” Dr. Jacqueline A. Eubany tells Newsmax Health.

“Women are not referred as often as men are for treatment, medication, or cardiac rehabilitation,” agrees Dr. Laxmi Mehta, director of the Women's Cardiovascular Health Program at Ohio State University Wexner Medical Center in Columbus, Ohio.

Here are key differences:

• Awareness: Although organizations like the AHA have focused on heart disease in women for years, women still are less likely to be aware of their risk than they are of breast cancer, for instance, says Eubany. “The Susan G. Komen Foundation has done an excellent job raising awareness of breast cancer, but heart disease isn’t there yet,” she says.
• Differences in testing: Women are less likely than men to be referred for diagnostic testing, studies find. In addition, a recent survey by Orlando Health found that most women are unaware of the age at which heart screenings should begin. The American Heart Association recommends women begin undergoing regular heart screenings, like blood pressure and cholesterol checks, at age 20, but the survey found the majority of women, 60 percent, thought screenings didn’t need to begin until after age 30, at least a full decade later.
• Symptoms: “Everyone knows that symptoms of a heart attack, like chest pain and pain that radiates down the arm, indicates a heart attack, but there are several studies that find women complain about shortness of breath, feeling weak and tired, or feeling nauseous and vomiting,” says Eubany.
• Delay: Partly as a result of the disparity in symptoms, women more often than men delay seeking emergency help. “Women tend to under recognize or deny them. When they do present to the emergency department, it is important for these symptoms to be triaged appropriately as potential heart problems,” adds Mehta. But women end to live alone more often, discuss getting help with their friends before calling 911, or fear embarrassment if they do call and the problem doesn’t turn out to be a heart issue, she adds.
• Biological differences: In men, a blocked coronary artery is the most common cause of a heart attack, but women can frequently have other types of heart attacks, such as from an intense spasm of the artery that can abruptly cut off blood flow to the heart. "We don’t yet clearly understand why women have different causes and symptoms of heart attacks," Mehta says. "Women are more complex, there are more biological variables such as hormonal fluctuations. That’s why more research is needed," she adds.
• Treatments: Recent research shows that women are less likely to be prescribed cholesterol-lowering statin drugs, and also less likely to receive an implantable defibrillator to prevent sudden cardiac death. “Women are also much less likely to be referred to cardiac rehabilitation programs,” says Mehta.

“Because of all these reasons, women miss getting help for their hearts, which can be tragic because studies show that women can lower their risk of heart attack and stroke by 80 percent with lifestyle changes,” says Eubany, author of the new book, "Women and Heart Disease: The Real Story."

Here are five ways Eubany says you can lower your heart attack risk:

1. If you smoke, quit. Smoking increases heart attack risk in women by 25 percent.
2. Diets don’t work. Instead, concentrate on making healthier food choices, like choosing grilled chicken instead of fried.
3. Reduce your risk factors. Take steps to control your blood pressure, cholesterol and diabetes.
4. Exercise. It doesn’t matter how low your exercise level is. You can start slow and gradually increase it.
5. Drink in moderation. If you drink, limit yourself to one five-ounce alcoholic beverage per day.