Breaking the Silent Killer: Understanding and Preventing Cardiovascular Disease in Women

By Dr. Rajiv Agarwal in Cardiac Sciences , Cardiology , Interventional Cardiology

Sep 25 , 2023 | 2 min read

Cardiovascular disease (CVD), also known as heart disease, refers to a group of conditions that affect the heart and blood vessels. It is a broad term that includes various disorders, many of which are related to the accumulation of fatty deposits (atherosclerosis) and plaque buildup in the arteries.

Types of Cardiovascular Diseases in Women

Cardiovascular diseases (CVD) in women include ischemic heart disease, heart failure, arrhythmia, hypertension, valvular heart diseases, congenital heart diseases, and peripheral heart disease.

High Risk Factors

The lifetime risk of developing CVD for a 40-year-old woman is estimated to be 1 in 2, the risk of developing CHD is 1 in 3, and the risk of developing heart failure and stroke is 1 in 5 each in her life span.

Awareness Gap

CVD is the most common cause of death in women, which has been proven in many research studies. Most women know that cancer, especially breast cancer, is a dangerous disease, but people are unaware of the seriousness of coronary heart disease.

Coronary heart disease in women occurs at least ten years later as compared with men, but mortality remains equal or higher.

Before 2010, people did not know that CHD was the most common cause of death in women until WHO raised the issue.

Symptoms and Presentation

The differences in the outcome of CHD in men and women are due to differences in presentation and treatment. The majority of women had sudden cardiac death without previous symptoms, whereas sudden cardiac death occurs in men with alarming symptoms and with obvious causes.

The presentation of acute coronary syndrome in women is more atypical rather than chest pain. They can present with just shortness of breath, jaw and shoulder pain, nausea, dizziness, lethargy, etc.

These symptoms are often ignored by women who avoid or delay medical attention. They are often missed by medical practitioners, leading to delays in diagnosis. This is the reason why more women present with cardiac arrest in the emergency ward. The in-hospital mortality rate due to acute myocardial infarction for women is also approximately double that in men.

Factors Responsible for Differences

Factors responsible for differences in women and men are:

Lesser awareness of CHD in women
Unusual presentations
Late hospital admission
Lesser care
More complications

The Way Forward

There should be a greater effort to reduce cardiovascular risk in women, especially after the age of menopause but also before it. This involves greater awareness in the general public that heart disease can strike women and that symptoms may not be clear. Women themselves should be motivated not to neglect their health in general and to seek urgent care for any acute symptoms as much as the men-folk.

Even medical professionals and doctors must be sensitised not to dismiss atypical symptoms, even in younger women, as merely due to anxiety.

Women should follow the same preventive strategies regarding diet, exercise, body weight, sugar, blood pressure, smoking and cholesterol as men.

Greater availability of health insurance will also ensure that more women come forward to seek urgent care and save lives.