Heart Health in Women

Cardiovascular disease is responsible for most deaths worldwide; around 18 million people die because of cardiovascular disease every year. World Heart Day, celebrated on 29 September this year, is a good opportunity to consider how to control cardiovascular disease and reduce morbidity and mortality for everyone.

The theme for World Heart Day is cardiovascular health for everyone.

More than 75% of CAD deaths occur in low to middle-income countries, affecting both men and women and more young people nowadays. Proper awareness and control of risk factors is the mainstay of reducing the risk of cardiovascular disease and its related mortality.

Most of us believe that heart attack is a disease that affects men and usually doesn’t affect women, while in reality, all over the world, more women die of heart diseases than men. 1 in 3 deaths in women is caused by CAD and 13 times more women die of CAD than of breast cancer. Most of us even do not know that the heart attack is reason for cardiac arrest.

There are multiple reasons for this high risk in women, the most common being lack of awareness and, at times, atypical disease presentation in women.

Common risk factors for heart disease in women are

1. Hypertension

2. Diabetes Mellitus

3. FH- IHD (family history of heart disease)

4. High cholesterol

5. Physical inactivity

6. Smoking

Risk factors are more common in women than men

1. Emotional stress (literal broken heart syndrome is real and more common in women)

2. Pregnancy and associated risk of SCD (coronary dissection)

3. Oral contraceptives and smoking pose a very high risk of CAD.

Also, women can have some atypical heart-related symptoms, leading to them being frequently misdiagnosed or their complaints being dismissed as anxiety.

Symptoms of a heart attack in women

As opposed to classical retrosternal chest heaviness and pain, the presenting symptoms of a heart attack in women can be atypical, like-

1. Gastritis or indigestion-like complaints

2. Pain in both shoulder / upper back or upper abdomen

3. Palpitation

4. Shortness of breath

5. Restlessness

6. Fatigue or feeling of general unwell

Unfortunately, women continue to be underrepresented in clinical trials. There is insufficient awareness among female patients and their doctors of gender-specific symptoms and presentations of CAD leading to adverse outcomes in women.

How can we prevent heart disease?

1. Healthy and balanced diet – Avoid fried and processed food. Include fresh food and plenty of fruits, vegetables and whole grains in your diet.

2. Maintain a healthy body weight

3. Regular physical exercises

4. Avoid tobacco/smoking

5. Manage stress, take time out for yoga, medications, relaxation, deep breathing

6. Keep your BP, sugar, and cholesterol under control
   

Psychological stress can double the risk of having a heart attack. We can maximise our individual heart health by exercising, meditating, and getting good sleep. Last but not least, take your medications as advised by your doctor.

As per WHO – 80% of heart attacks are preventable.

There is an urgent need for an increased understanding of CAD in women among both healthcare professionals and the general public. The more we know about heart disease in women, the better our chance of controlling it.