The May issue of Harvard Women's Health Watch offers suggestions on how women can identify coronary problems and begin to control their risk. Research has identified some gender differences that affect the incidence, diagnosis, and treatment of heart disease. They include

* Blood lipids: After menopause, women have higher levels of cholesterol, which may raise the risk of heart disease, especially in the presence of high triglycerides, a powerful contributor to heart disease in women. * Diabetes: In women, diabetes increases the risk of heart disease more than it does in men. * Smoking: Women who smoke are twice as likely to have a heart attack as male smokers. Also, the menstrual cycle worsens withdrawal symptoms, making it more difficult for women to quit. * Symptoms: During a heart attack, women don't experience the crushing chest pain that men do. Women's symptoms include shortness of breath; nausea; abdominal, neck, and shoulder pain. * Diagnosis and treatment: Women's smaller coronary arteries make it difficult to perform certain tests and surgeries on the heart. This reduces a woman's chance of getting a proper diagnosis and having a positive outcome. Women also tend to have more complications following surgery.