Are women dying needlessly from heart issues?

The fact that heart disease is less common in women, as compared to men is often misinterpreted as women being free of heart disease. A published 2020 report analysing the National Family Health Survey shows overall prevalence of undiagnosed hypertension in 18.69% women aged 15–49 years in India. In rural areas, it was 17.09% compared to 21.73% in urban areas.

Dr. P. Vinodh Kumar MD, DM, Senior Consultant Cardiologist and Clinical Lead, Department of Cardiology, Prashanth Superspeciality Hospital, Kolathur feels that the fault for this misconception lies mostly with women themselves. “As seen among many of my patients and their attendants, women even with multiple heart risk factors tend to downplay their symptoms that are obviously related to heart disease. In my practice, the incidence of women presenting with heart attacks is 10% of total cases and they usually present much later and also tend to self-medicate under assumption that it is probably a gastric symptom. This situation can only be changed by inculcating awareness of early identification of symptoms related to heart disease and it needs to be periodically checked for treating risk factors which majorly need self-care and self-nurturing.”

Dr. Ganesh Kumar, Head of Department Cardiology, Senior Consultant Interventional Cardiologist, Dr. L.H. Hiranandani Hospital, Mumbai adds, “Culturally I have seen that we are a bit dismissive about a woman’s symptoms and they are brought to health care rather too late. This is more prevalent in large joint families even in affluent classes where the decision maker is the head of the joint family. One more reason that I feel is that cardiac symptoms in women may not be the classic chest pain (angina), breathlessness etc, rather they tend to have more generalized and non-specific symptoms and these symptoms may not be easily picked up by a less experienced doctor. One needs to keep a higher index of suspicion for cardiovascular disease (CVD) in women and proper risk profiling needs to be done to rule out CVD.”


What makes women prone to heart issues?

It is a jarring fact that many women die of heart defects every year yet heart disease and related risk factors are often overlooked in women. Dr. Naveen Bhamri, Director and HOD – Interventional Cardiology, Max Super Speciality Hospital, Shalimar Bagh explains the possible causes. “High cholesterol, blood pressure and obesity are the main concerns for CVD but mental stress, lack of physical activity and low levels of estrogen post menopause are the other major factors which make women more prone to CVD. Interestingly, all these factors are ignored and take a back seat as women are busy taking care of rest of the family’s health, also, women tend to develop symptoms at a later age because they are often protected by high levels of estrogen till menopause. It is high time to prioritize women’s heart health.”

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Women with high blood pressure and/or high blood sugar during pregnancy are likely to develop hypertension and diabetes mellitus later in life compared to women who had an uneventful pregnancy. Such women are more prone to develop heart disease later in life. In the majority of these cases, the blood pressure and blood sugar normalizes after delivery. So they invariably don’t return for regular check ups. These women need close follow up at least once in a year after delivery to detect the onset of these risk factors at an early stage, shares Dr Saritha Sekhar, Associate Professor, Interventional Cardiologist, Amrita Hospital, Kochi.

Most of the women in urban areas, though aware, are multitasking, taking care of their career and family alike that they forget to take care of themselves. “The result will be that we miss the opportunity to diagnose these risk factors like high blood pressure or high blood sugar early enough to avoid complications,” adds Dr Saritha.

Symptoms of cardiovascular illness that women should look out for


Heart disease in women like men can present with chest pain, discomfort anywhere from the lower jaw till the navel with or without radiation to the left arm. Typical chest pain due to blockage in the blood vessel of the heart increases with exertion and is relieved with rest. But in women atypical presentations are common. The atypical presentations include vague chest discomfort, discomfort between the shoulder blades, excessive fatigue, breathing difficulty etc. Whenever a woman presents with any of these symptoms to a doctor, it is the responsibility of the doctor to assess the various risk factors already mentioned and decide to which extend the patient needs to be evaluated.

Health mistakes that make women prone to heart illnesses


Shivani Kandwal, Dietician and Nutritionist, Founder of Nutrivibes explains the most common mistakes

Not focusing on nutrition
Eating healthy is one of the most important things which you can do for your body to keep it healthy. Also eating unhealthily can lead to weight gain which can increase the chances of getting a heart disease. Select foods from every food group, including fruits and vegetables, whole grains, nuts and legumes, lean sources of protein. At the same time, you should avoid foods that are loaded with salt, added sugars and trans fats.

Smoking
Smoking does nothing good for your health, it only increases risk for heart attack and stroke by accelerating the buildup of cholesterol in the wall and also lowers the HDL which is the good cholesterol. So better to quit a habit that doesn’t serve you any good.

Sedentary lifestyle
Let me clear it up loud, women need to do actual exercise, not just moving around the house and running errands. Physical activity is key when it comes to preventing heart disease. So make sure that you take out at least 30 minutes to do any type of exercise every day.

Stress
We all have stress in our lives but what we can do is to manage it in a mindful way, women need to prioritize their mental health and increase their me time to reduce stress and optimize heart health.

Not getting routine health check-ups
Most women don’t get to know about their heart condition until and unless they get an emergency medical condition. Routine health checkups are very important for proper diagnosis and appropriate timely treatment of underlying disease.


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