Women and heart disease

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Paul Martiquet | September 27th, 2016

Ask yourself this question: Is a heart attack more likely for a man or a woman?

For a long time the common belief has been that heart disease is a man’s problem. This is very misleading but almost understandable because research has usually focussed on men’s experiences. Cardiovascular disease (CVD), which includes coronary heart disease, strokes and heart failure, has been identified with men partly because they tend to have heart attacks at an earlier age (65 years versus 72 for women). Women’s risk has been discounted for various reasons but CVD is the leading cause of death among women, just as it is for men.

Since 1980 overall coronary death rates have fallen by at least two-thirds. This huge improvement is attributable to reductions in risk factors via lifestyle changes and to better medication and medical treatment. Unfortunately, improvements for women lag behind those for men.

Coronary heart disease (CHD) is not the same in women as it is in men. For example, while risk factors are common to both genders, they can vary in degree. Take diabetes: it increases the chances of CHD for both, but increases the risk more than twice as much for women as for men. And high blood pressure is more strongly associated with heart attacks in women.

There are also differences in how heart attacks occur. At its simplest, a heart attack is caused by plaque build-up and clot formation in the coronary arteries, which block blood flow to the heart. Blockages form differently in women: they are more likely to develop in smaller branches of coronary arteries and to be less severe, but they are equally dangerous. We all know the symptoms of a heart attack include left-central chest pain, but fewer women exhibit this classic symptom. Instead, women are more likely to report other symptoms including fatigue, weakness, shortness of breath, dizziness, palpitations, nausea and pain in the jaw, neck or arm. These can be mistaken for a panic attack.

Because symptoms may not be instantly recognizable as a heart attack, women will often dismiss them or wait longer to seek help. Doctors, too, may not always recognize a woman’s symptoms, delaying treatment.

Women can take steps to reduce their chances of cardiovascular death and heart attack — yes, you men can take these steps, too. Step one: don’t smoke. Know your blood pressure and blood cholesterol levels and keep them under control. Choose a heart-healthy diet with lots of vegetable and fruit, nuts, beans and whole grains, and fish rich in Omega-3 fats. Cut back on the sodium in your diet. Get and stay active which in turn will help control your weight. Know your family history. You can’t do anything about it, but it should provide a warning of potential for heart disease and may trigger some of the actions to reduce the risks.

None of these suggestions is new or especially surprising, but have you considered making even one change that will reduce your risk of a coronary event? It could be of great benefit, and may make the second change easier. You deserve it, don’t you?

About the Author

Paul Martiquet
email iconPaul.Martiquet@vch.ca  

Educated at McGill and the University of Toronto, Dr. Martiquet practiced family medicine in Ontario before moving into the field of community medicine. As Medical Health Officer for rural Vancouver Coastal Health he works to improve the community’s health by providing support and advice about epidemiology, health promotion, disease prevention and public health protection.

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