Heart Disease in Women

Many studies and research have shown that there are differences in the cardiovascular system between men and women, which is reflected in how they both develop heart disease. Unfortunately, many women are not aware of the risks of heart disease and its impact on their health. Therefore, they are less aware than men of the risk factors and the resulting symptoms. On the other hand, the awareness campaigns, conferences and educational seminars have contributed to raising the level of awareness. 

Women have smaller blood vessels and heart chambers as well as fewer red blood cells. Hormonal changes that women experience during pregnancy, lactation and perimenopause affect their risk of developing heart disease later on.

Prior to menopause, women are 4 times less likely to experience a heart attack than men. Unfortunately, their lifestyle changes before reaching this age, in addition to unhealthy habits such as smoking, consumption of unhealthy food and emotional stress are all factors that contribute to developing heart disease in women. 

Estrogen helps reduce a person’s risk of cardiovascular disease. But menopause and surgical menopause cause estrogen levels to drop. As a result, a person faces a higher risk of blood clots, plaque in the arteries, and high cholesterol. Broken heart syndrome is a heart condition that’s often brought on by stressful situations and extreme emotions, which translated into heart failure. After menopause, the risk of developing heart disease as a result of experiencing emotional stress increases.

Several traditional risk factors for coronary heart disease — such as high cholesterol, high blood pressure and obesity — affect both women and men. But other factors may play a bigger role in the development of heart disease in women. Women with diabetes are more likely to develop heart disease than are men with diabetes. Also, because diabetes can change the way women feel pain, there’s an increased risk of having a silent heart attack — without symptoms. High blood pressure or diabetes during pregnancy can increase the mother’s long-term risk of high blood pressure and diabetes. These conditions also make women more likely to get heart disease. Smoking is a greater risk factor for heart disease in women than it is in men. Obesity, smoking, inactivity and emotional stress and depression are all risk factors that increase the risk of heart disease.

Coronary heart disease, a blockage of the arteries that supply blood to the heart, is the most common type of heart disease.

Coronary heart disease is when the coronary arteries become narrowed by a build-up of fatty material within their walls. These arteries supply the heart muscle with oxygen-rich blood. Coronary heart disease develops slowly over time and the symptoms can be different for everyone. 

Coronary heart disease is responsible for most heart attacks. Prevention is key. About two-thirds of women who have heart attacks do not recover completely. The risk of women developing coronary heart disease increases with age. But women of all ages should worry about heart disease.

Overweight and obesity are linked to higher LDL and triglyceride levels in the blood, which are all major risk factors of heart disease. Obesity is the cause behind heart disease, hypertension, diabetes among others; the World Health Organization has declared it as a major public health problem and a global epidemic. 

Heart Disease Risk Factors for Women

There are some risk factors that are common to both sexes, but they affect women differently. A woman with diabetes is more likely to develop heart disease than a man with diabetes.  The same goes for smoking, autoimmune disease or infections. In addition, there are other risk factors that are unique to women, such as those related to menstruation, menopause, or high blood pressure and diabetes during pregnancy. Heart disease risk factors for women include:

Pregnancy: Pregnancy stresses your heart and circulatory system. Preeclampsia greatly raises a person’s risk of developing hypertension and/or diabetes mellitus later in life. It raises the risk of a stroke. Gestational diabetes doubles a person’s risk of developing diabetes mellitus in the four months after delivery. It also raises the risk of cardiovascular disease throughout life.

Women’s health issues: Some health conditions, such as endometriosis, PCOS, gestational diabetes, or related complications such as pre-eclampsia, contribute to an increased risk of coronary heart disease.

Depression and loneliness: Depression is more common in women than in men, so they have more cortisol, known as the stress hormone, which is linked to heart disease. Depression increases the risk of heart disease, high blood pressure and cholesterol. Social isolation and loneliness increased the chance of developing heart disease. 

Heartbreaks: Women get more emotionally affected by the surrounding situations than men, making them continuously vulnerable to heartbreaks and depression, which in turn make them more susceptible to serious heart disease.

Reaching puberty before age 12: The earlier a woman reaches puberty, the greater her chances of developing heart disease. This may be due to high estrogen levels, which increase the chances of blood clots and heart attacks at an older age.

Acute influenza infection: Experiencing acute influenza infection increases the risk of heart attack and stroke, since it is caused by dangerous bacteria and viruses that can be transmitted to the heart, causing serious diseases.

Diet pills: Most types of diet pills are not effective and cause heart problems. They may raise blood pressure and increase the heart rate. 

Frequent infections: Rheumatoid arthritis usually affects women more than men, and it increases their chances of developing heart disease. It causes inflammation in the body and affects blood vessels. Therefore, doctors and nutritionists advise to eat more anti-inflammatory foods to prevent heart disease.

Who is at higher risk? 

The incidence of cardiovascular disease in women increases significantly after menopause, when the amount of circulating estrogen is reduced. However, this rate varies according to the woman’s health in general.

Heart disease risk factors in women include:

• High levels of cholesterol or triglycerides are among the diseases that put women at risk, because they gradually narrow the arteries of the heart, and their effect is worse in women due to their small heart arteries.
• Cigarette smokers are 6 times more likely to get heart disease than nonsmokers. Cigarette smoking doubles a person’s risk for stroke. Research shows that smoking can affect cholesterol, as people who smoke tend to have more LDL cholesterol than those who don’t.
• Women with diabetes are more likely to develop heart disease than are men with diabetes. Also, because diabetes can change the way women feel pain, there’s an increased risk of having a silent heart attack — without symptoms. People with diabetes have 2- 5 times the chance of getting cardiovascular disease than people without diabetes.
• High blood pressure is a contributing factor that increases the risk of developing heart disease in women; the normal blood pressure should not exceed 140/90, and its treatment should not be neglected because it causes atherosclerosis.
• Women face a higher risk of obesity when they go through menopause. They’re also more likely to gain abdominal (belly) fat, which is linked with a higher risk for heart disease. Having obesity is more dangerous for women than men. It increases a woman’s risk of coronary artery disease and nearly triples a woman’s risk for a heart attack.
• Emotional stress and depression: Women may experience broken heart syndrome, a heart condition that’s often brought on by stressful situations and extreme emotions. Women who have a heart attack are much more likely than men to have symptoms of depression at the time. Women are more likely to experience psychosocial stress, meaning their stress comes from work, home, money problems or major life events.
• Not getting enough physical activity can lead to heart disease—even for people who have no other risk factors.
• Women’s size: It is known that a woman’s body shape is biologically smaller than that of a man, and the same applies to the heart. Women have smaller hearts and coronary arteries and some experts believe that small coronary arteries may become blocked by atherosclerosis more easily than large arteries.

Symptoms of heart disease in women

The most common heart attack symptom in women is the same as in men — some type of chest pain, pressure or discomfort that lasts more than a few minutes or comes and goes. But chest pain is not always severe or even the most noticeable symptom, particularly in women. Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

• Nausea
• Sweating
• Shortness of breath
• Chest pain
• Unusual fatigue
• Upper back or abdomen discomfort
• Discomfort may radiate to the neck, jaw and shoulder

These symptoms can go away during times of rest, and the woman will feel fine and she was only experiencing signs of exhaustion or the hormonal change that comes with menopause. But in the meantime, the risk of a heart attack increases. As the disease progresses, different symptoms may appear in women, depending on the type of the disease. The woman may suffer from:

• Sweating
• Coughing
• Weight gain
• Heart palpitations
• Indigestion
• Heartburn
• Chest wheezing
• Stress and anxiety
• Headache
• Insomnia
• Fainting and dizziness
• Swelling of the feet and ankles.

Heart Disease Treatment

In general, heart disease treatment in women and in men is similar. It can include lifestyle changes, medications, angioplasty and stenting, or coronary bypass surgery.

After making lifestyle changes in terms of food, exercise and smoking, some health conditions such as diabetes, high blood pressure and cholesterol should be treated by taking medications to control their levels.

In other cases, the doctor recommends specific procedures such as coronary angioplasty, which is a procedure used to open clogged heart arteries. Angioplasty uses a tiny balloon catheter that is inserted in a blocked blood vessel to help widen it and improve blood flow to the heart.

Taking a daily aspirin can have a number of benefits for women. Aspirin prevents heart attacks and strokes, and it reduces the risk of heart disease. The patient should consult a doctor regarding the risks and benefits of aspirin.

Tips and advice to reduce the risk of heart disease

• Leading a healthy life can help reduce the risk of heart disease.
• Stop smoking and stay away from passive smoking.
• Eat a healthy diet, choose whole grains, fruits, vegetables, low-fat dairy products and avoid saturated or trans fats, added sugars and high amounts of salt.
• Exercise regularly
• Maintain a healthy weight
• Manage stress as much as possible. One of the ways to overcome stress is to exercise more, practice mindfulness exercises, connect with others and create social relationships to overcome loneliness.
• Stick to the treatment plan in case you are suffering from any medical condition such as blood pressure, anticoagulants and aspirin.
• Control other health problems such as high blood pressure, high cholesterol, and diabetes that increase the risk of heart disease.

Every woman can take small steps to protect herself from heart disease by following healthy habits throughout her life. Whether your heart disease is mild or severe, making lifestyle changes is an essential part of your doctor’s treatment plan.