It’s commonly believed that heart diseases affect men more than women. It’s a myth. In reality, heart disease is the foremost cause of death among women not only across the world but in Malaysia as well.

Basically, heart disease is deadly for anyone, although women face certain unique risks mainly due to their individualistic anatomy and hormones. In fact, women are at a higher risk of developing symptoms of heart failure.

Let’s explore the various aspects of heart disease in women in this article.

Cardiovascular Diseases in Women – An Overview

Heart disease in women affects women in unique ways. Women are different from men in many ways including in the aspects of anatomy, red blood cell counts, hormones and others. These impact a woman’s risk factors, symptoms and other aspects related to their heart health.

How is the Cardiovascular System of Women Different from Men?

Research has proven that there are sex-specific differences in the cardiovascular systems. These differences are pretty complex, often at a microscopic level. Some of the common examples include:

• Blood count: Women have fewer red blood cells than men, due to which they cannot inhale and carry as much oxygen as men at any given time.
• Anatomy: Women have smaller blood vessels and heart chambers than men. Their walls of ventricles are also thinner.
• Hormones: The oestrogen and progesterone levels of women are higher than men, while men have higher testosterone levels. These hormones affect a woman’s overall health, including heart health.
• Cardiovascular adaptations: Changes in posture (such as standing up suddenly after lying down) and changes in altitude affect women more than men. Their blood pressure may drop more suddenly.

Common Symptoms of Heart Diseases in Women

The most common symptom of heart disease is chest pain or discomfort in the chest. However, women may develop other types of symptoms that may indicate a heart disease. The common symptoms of a heart disease, especially a heart attack in women include pain in the chest, left breast, back or between the shoulder blades, throat or neck, one or both the arms, shoulders and one or both legs.

Women with heart disease may also develop other symptoms such as:

Early Warning Signs of Heart Attacks in Women

Many women experience early warning signs before a heart attack which are commonly known as prodromal symptoms. They can happen hours, weeks and even months before a heart attack. The most common warning sign is unusual fatigue. Other warning signs include:

You may not experience these symptoms all the time. They may also go away on their own. Many women ignore symptoms until it is too late. If you are experiencing any of these symptoms seek emergency medical help immediately.

Common Heart Diseases Experienced by Women

Like men, the most common cardiovascular disease among women is coronary artery disease. However, they are more susceptible to developing certain types of diseases such as:

• Coronary microvascular disease, the common symptoms of which are chest pain with a sudden tightening feeling. This typically happens during routine activities or rest. The blood flow through the smallest arteries can be interrupted in this disease leading to a higher risk of heart attack and other diseases. There can be small blockages, which can be very hard to detect through imaging tests.
• Broken heart syndrome, that can lead to strong chest pain or other symptoms that look like a heart attack. This can be caused due to stress from powerful emotions such as anger, deep grief or surprise. Women who have had no symptoms before may also suffer from this. Women who have experienced menopause are at a higher risk of developing this disease. It usually doesn’t cause any lasting damage.
• Variant angina, which can cause a rare type of strong chest pain caused by spasms in the heart arteries. This kind of pain is usually experienced during sleep and rarely causes a heart attack.

Risk of Heart Disease in Women

We all know that certain factors increase the risk of cardiovascular diseases in women such as obesity, cholesterol, high blood pressure and others. But certain factors play a crucial role in increasing the risk in women such as:

• Menopause: While women can develop heart disease at any age, the risk increases when their periods stop, usually when they are 55 years of age and above. Before menopause, a woman’s body makes more oestrogen which protects against heart diseases. During and after menopause, as the oestrogen levels drop, the risk of heart disease goes up. This is why women develop coronary artery disease 10 years later than men. If periods stop at an earlier age, the risk of heart disease becomes higher.
• Family history: Women with a family history of heart disease are at a higher risk of developing such conditions. If you have a history of heart disease in the family, it is important to keep a note of your heart health.
• Diabetes: If you have diabetes, the risk of heart disease goes up. Diabetes can also change the way you feel pain, which increases the risk of a silent heart attack.
• Smoking: Like men, smoking increases the risk of cardiovascular disease in women. However, the risk is higher in women, due to their physiological structure.
• Depression and stress: Depression and stress pose a higher risk of heart disease in women than in men. Both these emotional conditions can also make it difficult to maintain a healthy lifestyle and follow health advice recommended by your doctor.
• Lack of physical activity: Another major risk factor is inactivity.
• Pregnancy-related complications: Diabetes and high blood pressure during pregnancy not only pose a risk during pregnancy but also increase the risk of developing cardiovascular diseases in the long run.
• Inflammatory diseases: Certain inflammatory diseases such as lupus, rheumatoid arthritis and other inflammatory conditions increase the risk of heart diseases in both women and men.

Heart Failures in Women

Another common chronic condition in women is heart failure. This happens when the heart is unable to pump as much blood efficiently as it should. This can lead to fluid buildup in the body which usually gets worse over time. Common symptoms of fluid buildup include weight gain and swelling. Heart failure is quite common in men as well. However, the symptoms, causes and other aspects may differ between men and women.

Here are some interesting facts found through research:

• Diastolic heart failure is more common in women than men.
• The most common causes of heart failure are high blood pressure, diabetes, heart valve disease and coronary artery disease. Hypertension and heart valve disease are the more common cause among women while coronary artery disease is more common among men.
• Women face a higher risk of symptomatic heart failure after a heart attack.
• Heart failure induced by stress cardiomyopathy is more common in women than in men.
• Women with heart failure commonly develop depressive symptoms.

Are Tests and Treatments of Cardiovascular Disease Different for Women?

While tests and treatments are almost similar in both men and women, there are certain differences too. For instance:

• Women more commonly develop a smooth layer of plaque in the artery rather than a large piece of plaque (obstructive coronary artery disease). This kind of plaque is difficult to diagnose using a coronary angiogram. Hence, if you get tested, your results may be fine, but you may need more tests to find out the cause of your symptoms.
• Women are more likely to have ACE inhibitor intolerance (a kind of medication that lowers your blood pressure).
• Statins are a commonly used medication for lowering cholesterol levels. However, women are more likely to develop side effects from statins, which can hinder the treatment process.

However, your doctor will provide you with alternative treatment options if such situations develop. They will also keep in mind that you are a woman and follow the test and treatment procedure accordingly.

How can a Woman Prevent a Heart Disease?

Now that we understand heart diseases in women, let’s talk about how to avoid them and how to manage them.

The most important thing is to learn about the risk factors and work on changing them. A higher number of risk factors increases your chances of developing a heart disease. If you develop one risk factor, you might be fine for a while, but the chances of developing other risk factors continue to linger.

Hence, it is most important to control the risk factors. Two factors play a crucial role in such a scenario – lifestyle modifications and physical activity. Let’s take a deeper look into these.

Lifestyle Modifications

Having a healthy lifestyle reduces your risk of heart disease to a great extent. Here are some of the things to focus on:

• Eat a healthy diet: Opt for a diet rich in fresh vegetables, fruits, whole grains and lean meats. Choose fat-free or low-fat dairy products. Avoid trans fats, saturated fats, added sugars and high amounts of salt.
• Quit smoking: One of the foremost aspects of maintaining heart health is to avoid smoking. If you aren’t a smoker, don’t start. If you are a smoker, try to quit. It’s also important to remember that second-hand smoke can also damage blood vessels.
• Avoid alcohol: If you drink alcohol, do so in moderation. Up to one drink a day for women and two drinks a day for men is a healthy limit.
• Manage stress: Another very important aspect of maintaining a healthy lifestyle is to manage stress. Stress can lead to tightening of the arteries, increasing the risk of heart disease, especially coronary microvascular disease. Practicing mindfulness, getting some physical activity, and spending some time in nature are great ways to reduce stress.
• Manage other risk factors: If you have certain risk factors which can affect heart health such as high blood pressure, diabetes and high cholesterol, it’s important to keep them under control.
• Follow your treatment plan: It is most important to continue with your treatment plan and take medications regularly, especially hypertension medication, blood thinners and aspirin.

Exercise

Regular activity is an important aspect of keeping the heart healthy. Aim for at least half an hour of moderate exercise every day. If you can do more than that, then build up slowly. Even five minutes of exercise every day can have health benefits.

Certain other quick tips to include physical activity in your daily routine are:

• Take the stairs instead of the elevators.
• Walk or cycle to your work or to complete errands, rather than driving.
• Pace up and down in the room while watching television.

Heart Disease in Women – A Final Word

It is better to control the risk factors than to manage symptoms. Hence it is most important to maintain the condition of the heart. Living a healthy lifestyle in general with good food and adequate physical activity can work wonders. Pay attention to what you eat and how much. Try to include as much physical activity in your daily activities as possible. At the end of the day, no Beauty Shines Brighter than a Healthy Heart.

Sources:

• https://www.goredforwomen.org/en/about-heart-disease-in-women/facts
• https://www.cvskl.com/heart-disease-in-malaysia/
• https://my.clevelandclinic.org/health/diseases/-women-cardiovascular-disease
• https://medlineplus.gov/heartdiseaseinwomen
• https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease