One of the most enduring images of a heart attack is an elderly man clutching his heart in intense pain and passing out. Such a stereotypical image does more harm than good. For one, this only applies to elderly men of a particular type and not to all men or all age groups of men. Secondly, it comes nowhere close to how women experience a heart attack. While previously, most research on heart attacks was conducted on elderly men, in the last decade or more, women are increasingly under scrutiny for heart disease and this has unearthed interesting yet disturbing facts about women and their heart health.
Women all over the world are increasingly dying from, or have suffered one or more heart attacks. Heart disease is the leading cause of death for African American and White Caucasian women in the US, while for Asian, Hispanic and Oceanic women, it’s the second leading cause for death after cancer.
Cardiovascular Disease or CVD is an umbrella term for a wide range of heart and blood vessel conditions. This includes the more familiar heart attack, stroke, high blood pressure, angina, abnormal heart rhythms and heart failure. Lesser known conditions include coronary artery disease, peripheral arterial disease, heart valve disease, vascular disease, aorta disease, cardiomyopathy and congenital heart disease. Contrary to popular misconceptions, women are as much or more prone to these conditions as men. Research has uncovered why.
Risk Factors for Women
- Social factors: Culturally, women have been known to put their family health ahead of their own as a priority. While this aspect has changed in recent decades, women are still less likely to undergo periodic health checkups than men. There is also a wrong perception that heart disease is more prevalent in men and older women, so middle-aged women are less likely to go in for cardiac health screening. Many women do not show heart disease symptoms, which means, they could have suffered silent heart attacks without their knowledge, which increases the risk of a second attack. Further, many women dismiss heart ailment symptoms as signs of ageing, stress, general fatigue, gas or acid reflux.
- Atypical symptoms: Women experience heart attack symptoms quite differently from men. While men experience a typical shooting pain in the chest that radiates towards the arms, during an attack, women are more likely to feel pressure or tightness in the heart. They may also experience pain in the neck, jaw, throat, pain in the upper abdomen or back, nausea, vomiting and fatigue. In the month preceding an attack, women may also suffer from shortness of breath, indigestion, racing heart and disturbed sleep.
- Diabetes: Women with diabetes are more at risk of developing CVD than men with diabetes. Women with diabetes who have suffered a heart attack are clearly at the risk of a second attack.
- Metabolic syndrome: A deadly combination of factors such as obesity, high BP, low good cholesterol, high bad cholesterol and large waist-size increases the risk of developing heart disease, stroke and diabetes in women as compared to men.
- Heart structure: Women have smaller and lighter coronary arteries than men and hence more prone to blockage due to atherosclerosis or deposition of hard plaque in the arteries of the heart. This makes angiography, angioplasty and bypass surgery difficult. Further, small vessels means – higher than normal blood pressure increases the risk of a heart failure, as well as tearing of the arterial walls.
- Lifestyle: Smoking, alcohol abuse and a sedentary lifestyle increases the risk of developing CVD. Women who smoke are far more likely than men who smoke to develop CVD. Further, women find it more difficult to kick the habit compared to men. This risk applies equally to active and passive smoking. This means, even if the lady does not smoke, having a husband or partner who smokes at home increases the risk.
- Mental Health: Women who suffer from chronic stress or depression are at a higher risk of developing CVD. Such women are also less likely to take care of their overall health, creating a vicious cycle of risk factors that aggravate each other.
- Reproductive Health: Women who have had a premature menarche, who have suffered pre-eclampsia, high BP during pregnancy and premature childbirth are all at a risk of developing CVD. Further, women who have crossed menopause are at higher risk than younger women. This is because; the hormone oestrogen protects a woman’s heart by increasing good cholesterol and reducing bad cholesterol. Post menopause, this advantage is lost, so older women are at risk, especially in the smaller blood vessels (condition called coronary macrovascular disease).
- Broken heart syndrome: Stressful events in a woman’s life may trigger sudden release of stress hormones which can cause temporary inactivity of the heart muscles or a sudden stunning of the heart.
- Certain Medication and Ailments: Chemotherapy and radiation therapy used to treat conditions like breast cancer can increase the risk of CVD. Women who suffer from diseases like Lupus, rheumatoid arthritis and systemic sclerosis are at great risk of developing CVD.
Mitigating the Risk
- Regular Health check-ups: Women above 40 years of age must undergo annual health checkups for parameters like heart rate, BP, LDL and HDL, blood sugar among others.
- Quit smoking: If you do not smoke, do not begin, and if you smoke, quit at the earliest.
- Exercise and activity: Daily exercise, which includes any of these jogging, swimming, brisk walking, yoga, cycling or callisthenics.
- Healthy diet: A diet rich in whole grains, fruits and vegetables, low-fat dairy and lean meat. Avoid saturated fat, trans fats, added sugar and excess salt.
- Manage stress: Yoga, meditation, adequate sleep, relaxation techniques and having a hobby are known to reduce stress. If you suffer from depression, seek professional help.