Written by Dr Sanjeev Gera
Contrary to popular belief, women are as vulnerable to heart ailments as men. In India, cardiovascular diseases are found to be among the leading causes of mortality among women, especially in urban areas and estimates show that 16.9. per cent of all deaths in women resulted from cardiovascular diseases.
Studies at Harvard Medical School have shown that “a woman’s symptoms are often different from a man’s. Before menopause, a woman’s own estrogen helps protect her from heart disease by increasing HDL (good) cholesterol and decreasing LDL (bad) cholesterol. After menopause, women have higher concentrations of total cholesterol than men do. But this alone doesn’t explain the sudden rise in heart disease risk after menopause. Elevated triglycerides are an important contributor to cardiovascular risk in women. Low HDL and high triglycerides appear to be the only factors that increase the risk of death from heart disease in women over age 65.
“Diabetes increases the risk of heart disease in women more than it does in men, perhaps because women with diabetes more often have added risk factors, such as obesity, hypertension, and high cholesterol. Although women usually develop heart disease about 10 years later than men, diabetes erases that advantage. In women who’ve already had a heart attack, diabetes doubles the risk for a second heart attack and increases the risk for heart failure.”
Harvard Medical School research suggests that, for women, metabolic syndrome, characterised by large waist size, elevated blood pressure, glucose intolerance, low HDL cholesterol, and high triglycerides is the most important risk factor for having heart attacks at an unusually early age. In a study of patients undergoing bypass surgery, metabolic syndrome produced a greater risk for women than it did for men.
“Many women do not experience typical chest pain which makes early diagnosis and treatment difficult. Often due to responsibilities at home and at work, women tend to ignore their own well-being and dismiss mild symptoms as a routine niggle. But women must be aware that they too are vulnerable to heart diseases and should ensure regular check-ups as well as pay attention to any worrisome symptoms that need medical intervention. Peri-menopausal women, especially, are at higher risk,” says Dr Sanjeev Gera, Director & HOD, Cardiology, Fortis, Noida
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One must not ignore heart attack symptoms — aching, heaviness or burning sensation in the chest, pain in one or both arms or left shoulder, throat or jaw, shortness of breath or cold sweat, extreme fatigue and so on.
Often women do not undergo regular preventive heart check-ups to determine if there are any signs of heart disease. Many a time, patients reach hospitals with heavily blocked arteries that increase their risks like formation of blood clots, which can lead to 100 per cent blockage of coronary arteries, leading to a heart attack. Dr Gera suggests the following preventive regime:
1) The first step is awareness about the risk factors that cause blockages like high blood pressure, diabetes, high cholesterol, obesity, smoking, sedentary lifestyle and stress which worsen outcomes.
2) One must avoid smoking or use of tobacco in any form and even passive smoking.
In today’s time, most working women spend endless hours on the chair and do not commit time for physical activities.
3) Take up any kind of outdoor sport, jogging, walking, cycling, swimming or indoor activities such as gym, dancing, yoga or any such similar activity. It’s imperative to engage in physical activities for 30 – 45 minutes every day and up the time if you’re overweight.
4) Another key aspect is to watch for your diet. Excessive consumption of junk food, packaged food, aerated drinks food must be avoided. Check your calorie intake and look for heart-healthy diets which must include enough complex carbohydrates, legumes, fruits and vegetables with less of sugars, salt and fats.
5) Obesity or weight gain should be monitored. Physical activities and controlled diet would help maintain a healthy weight. In India, women have many responsibilities and they often neglect their health concerns. Many women experience modest to high level stress and owing to many reasons are not able to get good quality sleep. This is detrimental to good heart health and measures should be taken to reduce stress and anxiety and they must not be sleep-deprived.
6) All women must go for regular health screening, which include home BP and sugar monitoring and an annual cardiac check that must include a lipid profile, HBA1C and an exercise cum ECG test to find out silent heart disease. In case any symptoms or risks are identified, then they must get detailed investigations done as per advice of cardiologists.