Heart Health & Women

Heart Health in Women.

According to the World Heart Federation, CVD is the leading cause of death for women worldwide. One in three women around the globe dies due to disease of the heart and blood vessels. Yet only around 50% of women under the age of 55 who had a heart attack were aware that they had factors that put them at risk for heart disease. Women can have CVD at any age, especially if they have risk factors like Obesity or hypertension, but are especially susceptible during pregnancy and menopause. Often, women are underdiagnosed and undertreated due to misconceptions in the general public as well as among medical providers that heart disease is uncommon in women.

While I was in medical training, I was taught that cardiovascular disease was more common in men. This misinformation has partly contributed to the underrepresentation of women in cardiovascular research. So, let us start with some basic definitions so we are all on the same page.

 What is cardiovascular disease? 

Cardiovascular disease is an umbrella term that includes diseases affecting the heart and blood vessels. Of which atherosclerosis is the most common cause of death in both men and women.

What is atherosclerosis? Atherosclerosis is a combination of fatty substances, cholesterol, cellular waste products, calcium, and fibrin, also known as plaque. Plaque causes your blood vessels to become narrow, making it hard for blood flow to occur. In instances where there is complete blockage of the arteries, it can cause heart attacks and strokes.

 What are the differences between men and women regarding heart health?

Anatomy: women have smaller blood vessels and heart chambers with thinner heart walls. The smaller size makes it easier for the heart muscles to have more significant damage to the heart walls with minimally blocked arteries.
 
While classic symptoms of heart disease, such as chest pain, chest pressure, and shortness of breath, are commonly experienced by both women and men, women have a higher tendency for non-classic symptoms, such as

• Unusual fatigue (most common). For instance, if a woman has been easily able to climb a flight of stairs and now, out of the blue, struggles to do that, underlying heart disease should be considered.
• Shortness of breath.
• Feeling dizzy or faint.
• Feeling hot or flushed.
• Indigestion.
• Fast heart rate.
• Numbness in their hands or fingers.
• Nausea or vomiting.
• Loss of appetite.
• New vision problems.
• Headache.
• Coughing.
• Choking sensation.

 What makes women more at risk for fatal heart disease?
As described earlier, women tend to have smaller blood vessels. They develop a blockage in their main arteries and a blockage in the smaller blood vessels, also called microvascular disease, which is harder to identify through standard tests available in most treatment centers. Also, given the smaller heart chamber size and thinner walls, some women can have heart attacks even without severe blockage in the arteries, also known as non-obstructive coronary artery disease. Other conditions such as early menopause, hypertension during pregnancy, gestational diabetes, Polycystic ovarian disease, autoimmune diseases such as RA, lupus, and peripartum cardiomyopathy, which is pregnancy-related heart disease, and the use of oral contraceptives, puts women who have had these conditions at a higher risk for having heart disease.

• Women tend to have more fat cells and hence have a higher tendency for Obesity and Metabolic syndrome – the co-existence of high blood pressure, Obesity, and high glucose and triglyceride levels
• They are more prone to adverse effects of Smoking, diabetes, and hypertension. Women with diabetes have a two-to-four-fold increased risk of developing heart disease than men with diabetes and often die after their very first heart attack. Women over the age of 60 are more likely than men to have hypertension but are less likely to have it well-controlled. The tendency to have poorly controlled hypertension is partly because women have a more challenging time tolerating medications, which makes them less compliant with taking their medications, and they are also more sensitive to sodium, as tiny amounts can cause their blood pressure to rise.
• High levels of C-reactive protein – a sign of inflammatory disease that can occur along with other cardiovascular risk factors.

When should women actively seek medical evaluation for heart disease:

- Those who have classic risk factors such as diabetes, high cholesterol, high blood pressure, and Obesity should be screened for heart disease.
- Women who suffer from depression and anxiety are more prone to having heart disease as often they find it hard to be motivated to follow lifestyle advice for disease prevention

What Lifestyle Changes Protect Your Heart? 

In my six pillars video, which you can access on my website https://www.drdeepa-tlc.org, I discuss various intentional lifestyle choices scientifically proven to support heart health. Please take some time to review this. 

Some well-known lifestyle strategies include

 quitting Smoking, 
eating more natural, unprocessed foods, 
exercising and maintaining a healthy weight, 
managing stress, 
Avoiding or limiting alcohol and avoiding recreational drugs 

In conclusion, if you or your loved one is at risk for heart disease, find a provider you like and trust, and carefully follow their guidance. Utilize lifestyle health coaches who help you stay the course and overcome mind blocks and self-limiting beliefs. If you need coaching or advice, please feel free to contact me. You can book a discovery call with me and plan your next steps to achieving a healthier tomorrow for yourself.