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The myth that women are somehow protected from coronary artery disease (CAD) and all its complications has clearly been disproved; However, many public and professional attitudes remain unaffected. In the US , Slightly less than half of the 500,000 annual deaths from myocardial infarction (MI) occur in women In contrast, annual mortality in women from breast and lung cancer, accidents, lung disease combined does not exceed 100,000 deaths, yet more women and their physicians fear complications and death from cancer.
Heart disease is a multifactorial disease Certain factors which are increasingly important in women are:
SmokingWhile the incidence of smoking in men is declining more women are smoking from a younger age. This is adding o the increasing burden of heart disease and peripheral vascular disease in women.
Physical inactivityModern life style has added comfort to our lives at the cost of less physical activity. Decreased physical activity is associated with diabetes, high blood pressure, raised cholesterol, increasing abdominal girth.
DiabetesBoth type 1 and type 2 diabetes are increasingly seen in women. The manifestation of diabetes in more severe in women and has a more sinister prognosis. Sedentary life style adds to the additional risk. Women are more prone to dilatation of the heart and diabetes induced small vessel disease of blood vessels of the heart. In addition women are more prone to diabetes related kidney disease and stroke.
MenopauseTraditionally women have been protected by oestrogens till menopause when these levels fall. The risk of heart disease increases and tends to follow the pattern of males. This myth is now busted as women have newer risk factors which has led to premature heart disease.
High blood pressureSedentary life style leads to weight gain which adds to the risk of hypertension. Excess consumption of salt, picked foods add to high blood pressure.
StressDepression is recognized has an increasingly important risk factor for heart disease, more so in women.
Sharp central chest pain associated with sweating is a well recognized symptoms of heart attack. However, most women do not suffer this classical symptom, particularly younger women ( 50 yrs of age).
Sharp central chest pain associated with sweating is a well recognized symptoms of heart attack. However, most women do not suffer this classical symptom, particularly younger women ( 50 yrs of age).
More common symptoms are fatigue, breathlessness tiredness, nausea, abdominal or back pain or pain in left breast. These are usually ignored or ill understood by women and health care personnel leading to misdiagnosis or delay in diagnosis with profound impact subsequent treatment and their subsequent lives.
There is increasing data which shows that women resent about 1 hr later than men to hospitals with heart attack. But you can imagine the disastrous impact this delay has on womens heart. We know that the earlier treatment is initiated the better are the in hospital and long term results of both Thrombolytic therapy (clot busting drugs) or Primary angioplasty to the blocked artery. It is no surprise that this delay of 1 hr causes more damage to their heart muscle, less effective therapy and hence , women are discharged with weaker heart after a heart attack. This leads to a worse long term prognosis with more heart failure and repeated admission to hospital, for control of heart failure. for them.
Correction of risk factors is the mainstay of prevention of heart disease.
