ACIBADEM – Women’s Hearts at Risk More Than Men’s

While the heart beats approximately 2.5 billion times during its lifetime, it carries oxygen, nutrition, hormones and a number of basic cells thanks to the millions of liters of blood it pumps throughout the body. To stop means that the basic functions of the body also immediately fail.

The data of the World Health Organization shows that, unfortunately, according to the total number of death worldwide, the leading causes are cardiovascular diseases, including ischemic heart disease and stroke. It has been reported that ischemic heart diseases are responsible for 16% of the total deaths in the world.

Studies show that while death toll due to heart disease in men has decreased steadily over the last 25 years, such a change has not been observed in women. Due to the positive effects of estrogen on the cardiovascular system, women at younger ages are more advantageous in terms of cardiovascular disease compared to men, while the difference between men and women disappears with menopause, and the risk of cardiovascular diseases begins to be seen at the same rates. Some conditions that have risk factors for cardiovascular disease, but do not show symptoms due to the effect of estrogen before menopause, prepare the ground for serious heart disease after menopause. Therefore, it is necessary to increase awareness of heart disease in women.

Cardiovascular Risk Factors for Women

The most common causes of cardiovascular health are obesity, smoking, hypertension, diabetes, high cholesterol and inactivity.

Obesity is an important problem in women. Obesity, both on its own and by causing high blood pressure, diabetes and elevated blood cholesterol levels, adversely affects heart health. High blood pressure and high cholesterol are often accompanied by high triglyceride levels. When pathological conditions such as insulin resistance, high cholesterol, and dysfunction of vessel wall cells are added together with obesity, the risk of heart disease increases considerably.

Unlike men, additional risk factors such as menopause, pre-eclampsia, gestational diabetes, gestational hypertension, cystic disease of the ovaries, breast cancer, depression-psychosocial factors also pose a risk for cardiovascular disease in women.

Estrogen, Pregnancy, Menopause

Estrogen is the dominant hormone in women. Estrogen has the ability to protect the integrity of the vessel wall cells and prevent wall thickening. In other words, it prevents the onset of atherosclerosis. It also has a regulatory effect on coagulation. It indirectly increases HDL levels, which is good cholesterol, and decreases LDL, which is bad cholesterol.

Decreased estrogen levels in postmenopausal women place a significant risk of developing cardiovascular disease in smaller blood vessels. Blockages in small arteries can restrict blood flow to the heart. Although it does not cause obvious symptoms most of the time, it prepares the grounds for cardiovascular disease for women.

Oral contraceptives used as a premenopausal contraceptive method are factors that increase cardiovascular risk, as they contain estrogen, as well as progesterone, which has the opposite effect of estrogen. Birth control pills alone increase the risk of cardiovascular disease. This increase is 7 times higher in smokers using birth control pills. Elimination of multiple risk factors in women is important to prevent cardiovascular disease and to reduce deaths.

In addition, although the cause cannot be fully explained, normal physiological changes during pregnancy may reveal underlying health problems in some women with certain risk factors. Even temporary, a negative pregnancy outcome can cause changes in the blood vessels and heart, increasing a woman’s risk of cardiovascular disease.

Female Heart Disease

Women’s hearts are smaller than men’s. The stroke volume of the heart is 10 percent less. Heart rate is high. The menstrual cycle causes changes in blood coagulation and electrocardiographic (ECG) findings. Although the vascular structure is thinner, the stenoses are long. The rate of obstructive stenosis is less common in women. The cause of a heart attack in women is not a blockage in the heart vessels, but a spasm or rupture.

Contrary to popular belief, cardiovascular disease cause more deaths in women than breast cancer. However, women do not understand a heart attack in time because of different symptoms than expected. It is noticed late. However, early diagnosis of a possible heart disease is important by detecting the symptoms early. While the most common symptom of a heart attack is pain in the form of pressure in the chest, this symptom is not seen in women who have had a heart attack for the first time. They mostly experience back and jaw pain, sudden onset of fatigue and shortness of breath. There may be complaints of sweating and pain in the upper abdomen mixed with stomach pain.

Except for Heart Attacks (when part of the heart muscle dies from loss of blood flow), women can get any type of heart disease. The most common type of heart disease among women is coronary artery disease such as Angina (chest pain from lack of blood flow), Heart failure (when your heart can’t pump enough blood to meet your body’s needs), Arrhythmia (a problem with the rate or rhythm of your heartbeat).

But there are certain types of heart disease which are less common, but affect women more often than men:

• They may feel chest pain caused by spasms (sudden narrowing) that block blood flow in the smallest arteries of the heart, often at rest or during routine activities. (Coronary microvascular disease)
• They may feel strong chest pain or a heart attack, caused by the stress of strong emotions such as deep grief, anger, or bewilderment, which often affect women after menopause and often cause no lasting damage. (Broken heart syndrome)
• There may be rare severe chest pains caused by spasms in the heart arteries during sleep. They can cause a heart attack. (Variant Angina)

Protection of Cardiovascular Disease

The best thing to do to prevent cardiovascular disease is to change your habits and make your daily life healthier. First of all, weight, blood pressure and cholesterol levels should be determined. Smoking should be stopped. If there is a family history of heart disease, heart failure, cardiomyopathy or other heart conditions, this detail should be shared with the doctor. When warning signs such as chest pain, shortness of breath, unexplained fatigue, fainting, dizziness and flu-like symptoms should be observed, a doctor should be consulted. A control examination should be done every 3 years until the age of 40, 4 times in total between the ages of 40-50, 5 times between the ages of 50-60, and once every year after the age of 60. If there is abnormality detected in any of these controls, then the frequency of control should be increased.

Regular exercise reduces the risk of cardiovascular disease. 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity, or a combination of both, is recommended. A heart-healthy diet should be preferred along with exercise.

Although cardiovascular disease is basically known as “men’s disease”, it is “women’s disaster”. It is less common in women, but it is much more lethal. Unfortunately, cardiovascular diseases are mostly seen as a male disease and its importance in women is not emphasized enough. Women should be aware of the cardiovascular disease that threaten them and learn and implement precautions to reduce the risk factors that lead to heart diseases. If we are aware of the danger, deaths caused by cardiovascular disease can be prevented.