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Heart disease includes coronary artery disease, heart defects, congenital heart defects, heart attack, etc. It is a common notion that heart disease is a man’s disease; however, there is a high prevalence of the same affecting women too. Despite various awareness attempts and increasing conversations over the past few years, only half the percentage of women recognise and acknowledge the threat of heart disease as the number one killer.
Symptoms in women are often different from men; the seriousness of the issue lies in the fact that women are more likely to succumb within a year from having a heart attack than men. It is also noted that women do not seem to have the same results as men do when it comes to anticoagulants (blood clot medication) or even after undergoing certain cardiac medical procedures. It is commonly understood that estrogen protects women from heart disease, but that’s not the case anymore.
Differentiating heart disease in women from men will help tune out symptoms and lead to early diagnosis and prevention. Here are a few differentiators:
Estrogen: Increase in HDL (good) cholesterol and decreasing LDL (bad) cholesterol due to estrogen present before menopause, helps protect women from heart disease. Postmenopause, cholesterol concentrations are higher in women than in men. Elevated triglycerides also contribute to the risk of cardiovascular diseases (CVD) in women. The risk of death due to heart disease is seen in women above 65 years due to low HDL and high triglyceride levels.
Diabetes: Women with diabetes face further risk factors such as obesity, high cholesterol and hypertension, hence greater the risk of heart disease. Women who have experienced a heart attack, if diagnosed with diabetes as well, stand a greater risk of a second heart attack, also increasing the threat of heart failure.
Difference in symptoms: The disease appears in smaller blood vessels of the heart also known as microvascular disease — that needs to be identified and treated promptly. The symptoms are not typically the classic crushing chest pain like in men. Women are more likely to experience:
Chest discomfort
Shortness of breath
Fatigue
Indigestion or nausea
Back, shoulder or neck pain
Tests: Angiograms are less effective in diagnosing microvascular disease. False-positive stress test is more common in females. Women are also more prone to stress cardiomyopathy and tend to have smaller coronaries and radial arteries.
Women are more prone to radial artery spasms following transradial interventions. Heart failure with preserved left ventricular ejection fraction is also more common amongst females.
While stated above, women in the age group of 40-50 years are at a higher risk of heart diseases due to many reasons.
However, statistics indicate that about 10%-15% of female patients with heart attacks today are in the age group of 25 to 35 years. Some of the causes include:
Adoption of sedentary lifestyle
Family history of cardiac diseases continue to be the number one culprit
Stress
Smoking
Air pollution, both indoor and outdoor is also a major contributing factor
Women can decrease the risk of heart disease by implementing the following tips:
Be more active: Get about at least 30 mins of daily moderate-intensity exercise
Follow a healthy diet: A heart-healthy diet includes a variety of fruits and vegetables, whole grains, and nuts. It is also important to reduce sodium intake and limit the intake of trans fats.
Quit smoking: The chances of a woman having a heart attack doubles due to smoking, so kick the butt.
Decrease stress: Chronic stress, as well as depression, could increase the risk of heart disease. Seek professional help, speak to a mental health expert.
Follow stress-reducing techniques such as meditation and yoga, get adequate sleep and speak to your loved ones.
(The author is a senior consultant in interventional cardiology.)