Ladies,mind your heart

Heart diseases have replaced cancer to become the leading cause of death among Indian women.

Written by Saba Rahman | Published:April 23, 2011 2:09 am

If you thought men were more vulnerable to heart attacks,think again. Over the past decade,heart diseases have overtaken all forms of cancer to become the leading cause of death among women in India,say cardiologists.

According to the World Health Organization,cardiovascular disease (CVD) will kill more women than men in India by 2040.

And the trend is showing like never before.

At the Christian Medical College,Vellore,a total of 251 women were treated in its cardiology unit last year,says Dr Sunil Chandy,Professor and Head,Cardiology,of the institute. The figure,he says,is higher than previous years and is only increasing.

At the Fortis-Escorts Heart Institute,New Delhi,for every 100 patients admitted from 2006 to 2010,around 25 were women.

Dr Aparna Jaiswal,a cardiologist at the institute,says: “Given the prevalence of CVD in the country,the number of women patients should have been around 40-45. In developed countries,the ratio of man versus woman is 2:1.”

According to the Centers for Disease Control and Prevention,US,heart disease is the number one killer of not only men but also women across the world.

Confirms Dr Atul Mathur,Director,Interventional Cardiology,Fortis -Escorts: “Though unknown to many,CVD have indeed become the most fatal disease among women,both in India and the world over,in the past 10 years.”

Referring to the first comprehensive and largest study of acute coronary syndromes in over 20,000 Indian heart patients published in The Lancet in 2008,Dr Mullasari Ajit,Director,Cardiology,Madras Medical Mission,says while there was a high percentage of men who were patients of heart attacks,the number of women was not only sizeable but also their age was less than 50.

According to a recent issue of the Indian Menopause Society,the estimated prevalence of coronary heart diseases is around 3-4 per cent in rural areas and 8-10 per cent in urban areas,representing a two-fold rise in rural areas and a six-fold rise in urban areas over the last decade. The incidence of CVD in Indian women,according to the IMS,has significantly risen.

While women seem to fear breast cancer more,one in 30 women dies of breast cancer versus one in three of heart diseases.

Dr V K Bahl,Professor and Head,Cardiology,All India Institute of Medical Sciences (AIIMS),says women have a “bikini approach” towards diseases — that is they believe that they are most susceptible to breast cancer. “But that was true around a decade ago. Now,women almost equal men in terms of cardiological risks.”

Heart diseases do visit women later than men. “Women initially have the advantage because the female hormone,estrogen,protects the heart,but menopausal women have declining estrogen levels and the risk equals that of men,” says Dr Bahl. But doctors also agree that heart diseases are now afflicting women at least a decade earlier than they would expect it.

Dr Mathur of Fortis-Escorts says modern women face more stress than their mothers and grandmothers. “More of them are coping with high-pressure jobs,and also looking after their homes,giving them heart disease 10-20 years earlier.”

Dr Jaiswal adds: “Earlier,while the usual age of women patients was around 60,that is the post-menopausal stage,now it’s around 40-plus. In fact,the myth that estrogen level protects women from heart diseases has busted.”

The rising incidence of CVD among women is blamed largely on the change in lifestyle.

“Long hours at work,lack of rest and high levels of stress is making a woman aggressive and vulnerable to CVD,” says Dr R Bhagwat,angioplasty expert,Nanavati Hospital,Mumbai.

Dr Jaiswal adds: “We are exercising little and eating junk food. There are those who use birth pills indiscriminately.”

Doctors also say that women in India do not have much access to healthcare facilities.

Dr Ajit of Madras Medical Mission says women are still thought to be a low-risk population as far as CVD is concerned. “A 42-year-old woman complaining of chest pain would rather be treated for indigestion and acidity rather than told to undergo a stress test or an ECG (electrocardiography).”

Dr Jaiswal attributes this to traditional mindset. “Their (women’s) illnesses are not given due importance. They are not being brought to hospitals for treatment.”

“Women in general do not avail of treatment and tend to ignore symptomatic pain that could cause a heart attack. Often,they remain underdiagnosed,” adds Dr Ajit.

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