Worldwide, heart disease is the leading cause of death in both men and women with its prevalence increasing over time in both. “The myth that heart disease is a ‘man’s disease’ needs to be debunked,” says Dr Saurabh Bagga, consultant (interventional cardiology), Fortis Hospital Shalimar Bagh.
“Women have their first presentation of heart disease a decade later than men, commonly after menopause. They are, however, less likely to call emergency service when experiencing symptoms of a heart attack themselves and are much more likely to die from their first heart attack than men,” he tells indianexpress.com
Heart disease can take many other forms and can result in heart failure due to weak and damaged or stiff heart muscle, arrhythmia or an abnormal rhythm of the heart and heart valve problems. The most common symptom of heart attack is some type of pain, pressure or discomfort in the chest. However, it is important to note that it may not always be severe or even the most prominent symptom in women.
“Women can experience different symptoms of heart attack than men. It is important to understand these differences as they can result in delay in seeking help or treatment and, thus, may lead to more complications. Heart attacks can also be silent,” says Dr Bagga.
Symptoms unrelated to chest pain maybe:
1. Shortness of breath.
2. Neck, jaw, shoulder, upper back or abdominal discomfort.
3. Pain in one or both arms.
4. Nausea or vomiting.
6. Dizziness or light-headedness.
7. Unusual or extreme fatigue.
These symptoms, according to the expert, can be commonly attributed to indigestion or stomach upset, stress and weight gain. Women can have symptoms of chest discomfort due to blockages not only in their main arteries but also in the smaller arteries that supply blood to the heart, a condition called small vessel heart disease or microvascular disease.
There are several factors which increase the risk for developing heart disease. These are:
1. High ‘bad’ cholesterol (LDL and Triglycerides) and low ‘good’ cholesterol (HDL).
2. High blood pressure
4. Diabetes: Women with diabetes are at greater risk of heart disease than are men with diabetes.
5. Smoking: Smoking is a greater risk factor for heart disease in women than it is in men.
6. Lack of physical activity.
7. Mental stress and depression make it difficult to maintain a healthy lifestyle and follow recommended treatment.
8. Menopause: Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease.
9. Certain chemotherapy drugs and radiation therapy for cancer.
10. Pregnancy complications: High blood pressure or diabetes during pregnancy can increase long-term risk for heart disease in women.
11. Broken heart syndrome: This condition, which can result from stressful situations, can cause severe, usually temporary heart muscle failure, more commonly in post-menopausal women. It is also called ‘Takotsubo Cardiomyopathy’ or apical ballooning syndrome.
Women of all ages should take heart disease seriously. Women under the age of 65, especially those with a family history of heart disease, should pay heed to the risk factors. They can make several lifestyle changes to reduce the risk of heart disease, suggests Dr Bagga.
1. Quit smoking: Women who quit smoking greatly reduce their risk of dying prematurely.
2. Manage diabetes. Monitor blood sugar, control diet, exercise regularly and take medication as prescribed.
3. Monitor and keep blood pressure under control: High blood pressure has no symptoms, so it’s important to have your blood pressure checked regularly.
4. Monitor and lower cholesterol: Take medication as prescribed.
5. Stay active: Everybody should try and do moderate exercise, such as walking at a brisk pace or any aerobic activity of their choice, most days of the week. 150 minutes a week of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of both is recommended. That is, about 30 minutes a day, five days a week.
6. For more health benefits, aim for 60 minutes a day, five days a week. Also aim to do strength training exercises two or more days a week. If one can’t get all your exercise completed in one session, try breaking up your physical activity into several 10-minute sessions during a day. One can make other small changes to increase physical activity throughout the day. Try taking the stairs instead of the elevator, walking or riding your bicycle to work or to do errands, or doing sit-ups or push ups while watching television or taking walks in between meetings.
7. Lose weight: Losing even a small amount of weight can help reduce your risk of heart disease. What is considered a healthy weight varies from person to person but having a normal body mass index (BMI) is helpful. Measuring waist circumference and calculating the waist-hip ratio is a useful tool to measure whether or not a person is overweight.
8. Eat healthy: Eat a healthy diet that includes whole grains, a variety of fruits and vegetables, low-fat or fat-free dairy products, and lean meats. Avoid saturated or trans-fat, added sugars, and high amounts of salt.
9. Limit alcohol intake: No more than one drink a day. Recent data, however, indicate that even that maybe harmful.
10. Manage stress levels by finding healthy ways to cope with stress like yoga and meditation or seek medical help.
Heart disease treatment in women and in men is similar.
“Treatment may include medications, angioplasty and stenting, or coronary bypass surgery and are effective for both men and women. However, women who don’t have typical chest pain are less likely to be offered these potentially lifesaving options. Lastly, it would be prudent to note that hormone therapy, antioxidant vitamin supplements (vitamin E, C, and beta carotene), folic acid, with or without B6 and B12 supplementation should not be used for the primary or secondary prevention of cardiovascular disease,” says Dr Bagga, adding routine use of aspirin in healthy women 65 years of age is not recommended to prevent heart disease.