Heart disease: Women are equally at risk as men

Women may experience different symptoms of heart disease compared to men; some of these are — burning in the chest, nausea, unusual fatigue, exhaustion, dizziness, or even stomach ache.

• Estrogen and Women’s Heart Health
• Symptoms of heart disease in women
• Women with a higher risk of heart disease

Did you know that heart disease is a leading cause of death in women? But not all women are aware of it. Heart disease is usually spoken about in the context of men. A few years ago, the American Heart Association conducted a study and asked women if they were aware that heart disease is the leading cause of death in women, only about half of those surveyed said that they did. Similarly in India, women are not necessarily aware that they are at risk of heart disease.

Generally, in a country like India, women’s health receives attention only during pregnancy and the immediate postpartum period, says a study. Another study that compared the prevalence of cardiovascular diseases in men and women across different age groups, between 2000-2015, and it found that women often suffer from heart disease at a later age as compared to men. It was also determined that women are physically and psychosocially more affected by cardiac disease compared to men.

Estrogen and Women’s Heart Health

Doctors say that before menopause, the female hormone estrogen helps protect women’s cardiovascular health by maintaining a healthy level of “good” cholesterol. “Estrogen lends a protective cover to women,” says cardiologist Dr. Sunil Kumar Maheshwari. However, these benefits are lost post menopause, when their risk of heart disease increases. Post menopause, women have higher concentrations of total cholesterol compared to men. Even women smokers are at a higher risk of heart attacks compared to male smokers. “When estrogen levels are at their peak in the child bearing age, you see very little incidence of heart problems in women, which unfortunately can be negated by smoking. If one is a woman of child bearing age, in her 30s or late 20s or even early 40s, the estrogen is saving her from heart problems, but if she smokes, she will have twice the chances of developing heart problems,” says Dr. Maheshwari.

Doctors say that before menopause, the female hormone estrogen helps protect women’s cardiovascular health by maintaining a healthy level of “good” cholesterol. However, these benefits are lost post menopause and that’s when their risk of heart disease increases.

The lack of knowledge is one of the reasons that symptoms in women often go unnoticed. The lack of awareness amongst women themselves is dangerous because this means they don’t pay attention to precautionary measures when it comes to their diet and lifestyle, which are essential for maintaining good heart health. The symptoms of heart disease in women are also sometimes underestimated by healthcare professionals, according to the U.S. Department of Health and Human Services – National Institute of Health.

Symptoms of heart disease in women

The symptoms of heart disease are different in women. While men are more likely to have acute chest pain, women may experience symptoms like extreme fatigue or sleep disturbance. Women also experience cold sweats, fatigue, shortness of breath, weakness, and dizziness. One study said that less than a third of the women in a survey reported any early warning signs involving chest pain or discomfort.

The symptoms are also different in women. While men are more likely to have acute chest pain, women may experience symptoms like extreme fatigue or sleep disturbance. Women also experience cold sweats, fatigue, shortness of breath, weakness, and dizziness.

An article from the University of Rochester Medical Centre says the main symptoms are: recurring pain or discomfort in the chest that lasts more than a few minutes; discomfort; pain which spreads to the arms, neck and the jaw from the chest; and, exhaustion and stomach ache.

“Women’s symptoms tend to be more subtle and less predictable, leading to potentially detrimental outcomes. Women often underestimate the danger of cardiovascular disease, and may fail to take preventive measures, heed warning signs, or seek treatment for symptoms,” according to a study by the U.S. Department of Health and Human Services.

Women with a higher risk of heart disease

Women with endometriosis, polycystic ovary disease (PCOD), diabetes, or pregnancy-related high blood pressure are also at a higher risk of heart attacks. Therefore, women suffering from these should take preventive measures. In India, research says that women over 40, from lower socio-economic status and those widowed/divorced are at elevated risk, and treatment-seeking is higher in women over 40, from upper socio-economic status and those married.

Women with endometriosis, polycystic ovary disease (PCOD), diabetes, or pregnancy-related high blood pressure are also at a higher risk of heart attacks.

The important thing is that men and women both need to be aware that they are equally at risk of heart disease. And, preventive measures like regular exercise, quitting smoking, eating a heart-healthy diet, managing stress, keeping your cholesterol levels and blood pressure under check, and getting regular medical check-ups are extremely important.

Dr Maheshwari suggests that women should get a blood pressure test at least once in six months, and not later than once a year, or whenever they experience symptoms like headaches, palpitations, anxiety or panic. “Blood pressure should not go above 120/80. Cholesterol levels should not be more than 200. Abdominal fat is also a factor, obesity is a factor. Physical inactivity is a factor. Women should get regular check ups done if there is a history of premature heart problems in the family or if she has had an early menopause, or if she is over 50,” he adds.

Sources:

1. Framing Women’s Health Issues in 21st Century India – A Policy Report The George Institute for Global Health India, May 2016​.
2. Determinants of cardiovascular disease and sequential decision-making for treatment among women: A Heckman’s approach.​ ​Raman Mishra​ and ​Monica
3. Subtle and Dangerous: Symptoms of Heart Disease in Women. U.S. Department of Health and Human Services – National Institutes of Health.
4. Heart Attacks and Women. University of Rochester.

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