It is true that men have generally been known to be at a higher risk for heart attacks and heart disease but it is also a common misconception that women are not vulnerable. In fact, heart disease is the leading cause of death for both men and women worldwide.
The conversation over the increasing incidence of heart diseases and cardiac arrests gained momentum after the death of popular celebrities, including singer KK, Kannada superstar Puneeth Rajkumar, TV actor Sidharth Shukla and director Raj Kaushal.
All the discussions primarily centred on the topic from the perspective of the male anatomy but what makes women vulnerable to heart attacks?
According to experts, women and men have unique anatomical and hormonal characteristics that can impact their risk of heart disease and stroke.
Did you know that women experience different symptoms during a heart attack than men? These are “subtler signs” such as fatigue, shortness of breath, and pain in the jaw or back rather than the classic chest pain.
As they experience different symptoms than men, it leads to under-diagnosis and delayed treatment, posing a challenge to timely intervention.
Often, the symptoms in women are misdiagnosed and severe heart conditions could be missed. Also, social and cultural factors play a bigger role in which women do not take care of their own wellness.
“There is a widespread misconception that women are protected from heart disease. However, this is not true,” said Dr Vivek Chaturvedi, head, department of cardiology at Amrita Hospital in Delhi-NCR.
For instance, Chaturvedi said some cardiovascular diseases such as “rheumatic mitral valve disease” and “takayasu arteritis” are actually more common in women. “The prevalence of many heart diseases like hypertension-related heart diseases is similar in men and women.”
While men have a higher risk of developing heart attacks and strokes, women are not far behind, he said. “This is especially true for contemporary times when women are suffering from several lifestyle-related risk factors which were partially responsible for increased risk in men.”
He added: “Also noteworthy is the fact that women with heart disease can frequently have atypical symptoms, which along with socio-cultural inequities often lead to delayed diagnosis and more complicated course.”
What are the top symptoms?
Women often describe heart attack pain as pressure or tightness rather than the classic presentation of crushing chest pain that accompanies heart attacks.
The other symptoms include neck, jaw, shoulder, upper back or abdominal discomfort. Also, women complain of shortness of breath, pain in one or both arms, nausea or vomiting, sweating and light-headedness.
What puts women at risk?
“Some factors may play a bigger role in the development of heart disease in women as compared to men,” Dr TS Kler, chairman at Fortis Heart and Vascular Institute, Fortis Gurugram, told News18.
He said that if a woman is diabetic, she is more likely to develop heart disease than men.
“Similarly, if she has emotional stress or depression, it will affect her heart more than men’s. Also, smoking is a greater risk factor for heart disease in women than it is in men,” Kler said, adding that family history of early heart disease also poses a greater risk factor in women than in men.
According to Dr Vyom Mori, consultant cardiologist at Narayana Multispeciality Hospital in Ahmedabad, “hormonal changes” in females during menopause play a crucial role.
“Declining estrogen levels lead to unfavourable changes in blood cholesterol levels and blood vessel function,” he said.
Additionally, Mori said conditions such as polycystic ovary syndrome (PCOS) and pregnancy-related complications like gestational diabetes and preeclampsia can increase a woman’s risk of developing heart disease later in life.
Dr V Rajasekhar, interventional cardiologist and electrophysiologist at Hyderabad-based Yashoda Hospitals, quoted a Polish study which found that cardiovascular diseases, including coronary artery disease (CAD), are the leading cause of death among women and men.
The study published in 2018 found that mortality among women is higher than in men. The study also stressed that women more often report “atypical anginal symptoms”.
“In women, the issue of CAD is underestimated, which results in its under-diagnosis and under-treatment,” Rajasekhar said. “Many are not aware of the fact that heart disease is the number one killer in females. Unfortunately, in many, it is a silent killer,” he said, quoting a study which found that almost half of women who had a heart attack before the age of 55 had no prior inkling of being at risk for such an event.
Women who develop blockages in their arteries are often found to have smaller coronary arteries which are more difficult to treat either with stents or bypass, Rajasekhar said.
“Their heart chambers are smaller and the walls of the chamber are thinner, putting them at higher risk of complications.”
Women are also more likely to have postural changes in blood pressure and are also likely to have more side effects due to medications. “Though women are likely to develop heart disease a decade later in life than males, when they do develop heart disease, it is likely more severe and more difficult to treat.”
What should be done?
Dr David Rozario, consultant, adult cardiology at Narayana Superspeciality Hospital in Howrah, echoed similar points, calling age a significant risk factor for women.
“As women get older, their risk of heart disease increases. After menopause, women’s risk catches up to that of men.”
Rozario said it is important for women to be aware of these risk factors and take proactive steps to maintain heart health.
“Regular exercise, a balanced diet, avoiding tobacco use, managing stress, and seeking regular medical check-ups can all contribute to reducing the risk of heart disease in women.”
Consulting with healthcare professionals for personalised advice is crucial to managing individual risk factors effectively.
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