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World Heart Day –September 29

How is Heart Disease in Women Different?

By Dr. Zakia Khan, Senior Consultant, Interventional Cardiology, Fortis Hospital, Kalyan

Heart disease is referred to various types of heart conditions that also include Coronary Artery Disease, heart defects, congenital heart defects, Heart Attack, etc. It is a common notion that heart disease is a man’s disease; however, there is a high prevalence of diseases of the heart in women too! Despite various awareness attempts and increasing conversations over the past few years, only about half (46%) of women recognize and acknowledge the threat of heart disease as the number 1 killer. This WORLD HEART DAY, let us understand how Heart Disease is different in women, and why it is of utmost importance to pay heed to.

Heart disease symptoms in women are often different from men; the seriousness of the issue lies in the fact that women are more likely to succumb within a year from having a heart attack than men! It is also noted that women do not seem to have the same results like men do when it comes to Anticoagulants (blood clot medication) or even after undergoing certain cardiac medical procedures. It is commonly understood that Estrogen protects women from Heart Disease, but that’s not the case anymore.

Differentiating heart disease in women from men will help tune out symptoms and lead to early diagnosis and prevention, here are a few differentiators:

ESTROGEN: Increase in HDL (good) cholesterol and decreasing LDL (bad) cholesterol due to Estrogen present before menopause, helps protect women from Heart Disease. Post menopause, cholesterol concentrations is higher in women than in men. Elevated triglycerides also contribute to the risk of Cardiovascular Diseases (CVD) in women. The risk of death due to Heart Disease is seen in women above 65yrs due to Low HDL and high triglyceride levels as contributing factors.

DIABETES: Women with Diabetes are often faced with further risk factors such as Obesity, high cholesterol and Hypertension, hence greater the risk of Heart Disease. Women who have experienced a heart attack, if diagnosed with Diabetes as well, their risks of a second heart attack increases twofold, also increasing the threat of heart failure.

DIFFERENCE IN SYMPTOMS: Amongst women faced with heart disease, the disease appears in smaller blood vessels of the heart also known as micro vascular disease – that needs to be identified and treated promptly. The symptoms are not typically the classic crushing chest pain like in men. Women are more likely to experience:

  • Chest discomfort
  • Shortness of breath
  • Fatigue
  • Indigestion or nausea
  • Back, shoulder or neck pain

Tests: Angiograms are less effective in diagnosing Micro vascular Disease. False positive Stress Test is more common in females. Women are also more prone to Stress Cardiomyopathy, and tend to have smaller Coronaries & Radial Arteries. Women are more prone to Radial Artery Spasms following Transradial Interventions. Heart failure with preserved Left Ventricular Ejection Fraction is also more common amongst females.

While stated above, women in the age group of 40-50yrs are at a higher risk of Heart Diseases due to many reasons. However, statistics indicate that about 10%-15% female patients with Heart Attack today are in the age group of 25 to 35yrs! Some of the causes include:

  • Adoption of sedentary lifestyle
  • Family history of cardiac diseases continue to be the #1 culprit
  • Stress
  • Smoking
  • Air pollution, both indoor and outdoor is also a major contributing factor

Women can decrease the risk of Heart Disease by implementing the following tips:

  • Be more active: Get about at least 30mins of daily moderate-intensity exercise
  • Follow a healthy diet: A heart-healthy diet includes a variety of fruits and vegetables, whole grains, and nuts. It is also important to reduced Sodium intake and limitthe intake of Trans Fats
  • Quit smoking: The chances of a woman having a heart attack doubles due to smoking, so kick the butt!
  • Decrease stress: Chronic stress as well as Depression could increase the risk of heart disease. Seek professional help; speak to a Mental Health expert. Follow stress reducing techniques such as meditation and yoga, get adequate sleep and speak to your loved ones

Heart Diseases in women are not detected early, primarily because they put the family’s needs before themselves. Remember, lifetime risk of a woman dying from heart disease is eight times greater than that of Breast Cancer! So look after your overall health, begin early check-ups, and schedule annual checks as prescribed by your doctor.

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