Heart disease is the number one cause of death among men and women worldwide. Although men have a greater risk of heart attack than women do and have attacks earlier in life, it is no longer just a man’s problem. Cardiovascular diseases, which include stroke, cause 1 in 3 deaths among women each year — more than all cancers combined. They claim the life of a woman about every 80 seconds. Fortunately, this can be changed, because 80 percent of cardiovascular diseases may be prevented.
The more a woman knows about heart disease, the better is her chance of beating it. In two consecutive issues, this column will try to help empower women in facing the threat of heart disease through awareness of the symptoms and risk factors unique to them, as well as treatment and prevention.
Heart Attack Symptoms in Women
A woman’s symptoms often differ from a man’s. The most common heart attack symptom in women is some type of pain, pressure, or just discomfort in the chest. It may not be severe or even the most prominent symptom. In fact, some women may have heart attack without chest pain. Women are more likely than men to have heart attack symptoms not related to chest pain, such as pain in one or both arms, back, or neck; stomach pain; shortness of breath; nausea or lightheadedness; sweating; and fatigue.
This may be because women tend to have blockages not only in their main arteries but also in the smaller arteries that supply blood and oxygen to the heart — a condition called small vessel heart disease or microvascular disease. Women’s symptoms may occur more often at rest, or even during sleep.
Women may be diagnosed late or get treated only after a heart attack has already occurred, because their symptoms are not classic or typical, and women may downplay their symptoms. Hence, if you experience these symptoms or think you are having a heart attack, call for help immediately.
Heart Disease Risk Factors in Women
High blood pressure, high cholesterol and obesity are traditional risk factors for coronary artery disease affecting both men and women. However, other factors may play a bigger role in the development of heart disease in women. These factors include:
Diabetes. Women with diabetes are at a greater risk of heart disease than are men with diabetes. The risk of heart disease in women with diabetes is increased as much as 6-fold.
Mental stress and depression. Stress and depression affect women’s hearts more than men’s.
Smoking. In women, smoking is a greater risk factor for heart disease than it is in men. It accounts for a majority of heart attacks in women under the age of 45.
Inactivity. A sedentary lifestyle or physical inactivity is a major risk factor for heart disease, and some research has found women to be more inactive than men.
Metabolic Syndrome. This is a group of risk factors or conditions including high blood pressure, elevated blood sugar, large waist size, low High-Density Lipoprotein (HDL) cholesterol, and high triglycerides. It may occur in men and women. Although metabolic syndrome is particularly common in post-menopausal women, research suggests that it is the most important risk factor for having heart attacks at a usually early age among women.
Menopause. Low levels of estrogen after menopause may pose an important risk factor in developing small vessel heart disease or microvascular disease.
Broken heart syndrome. Also called takotsubo cardiomyopathy or stress cardiomyopathy, this condition is often brought on by stressful conditions that cause temporary but severe heart muscle failure. This occurs more commonly after menopause.
Pregnancy complications. High blood pressure and diabetes during pregnancy can increase women’s long-term risk of developing high blood pressure and diabetes, and increase the risk of heart disease in the mothers.
To keep the chances of developing heart disease and stroke as low as possible, it is critical for women to know the heart attack symptoms and risk factors unique to them. In next week’s issue, this column will highlight what women can do to reduce their risk of heart disease.
Dr. Rhodette Enriquez Arevalo is an internist and a cardiologist. She is an advocate of teaching people with Hands-Only Cardiopulmonary Resuscitation and the Use of Automated External Defibrillator for a CPR-Ready and AED-Equipped Philippines.