Sex/Gender Differences in Cardiovascular Diseases On Women’s heart day…

Cardiovascular diseases are the leading cause for death both with the male and the female population. This group of heart and blood vessels diseases comprises:

increased blood pressure, coronary artery disease (disease of the heart blood vessels), heart attack, heart failure, heart valve disease, as well as heart rhythm disorders. In spite of this, the awareness and the education concerning heart diseases among women is at a rather low level. Cardiovascular diseases can have different symptoms with men and women, which imposes different approach to diagnosis, different treatment and eventually, it sometimes has a different outcome.
Although women can be affected with heart diseases at any age, some of the risk factors are increased in the menopause, usually at the age of 51-54. Menopause by itself is not a reason for heart disease, however, it is a period in life when women must be cautious about all the risk factors. In fact, the risk of heart attack for women is much lower before the menopause, than for men of the same age, but in 10 years’ time after the menopause, the rate is equal.
The estrogenes, female hormones that have a positive effect on the blood vessels because they maintain their elasticity, are the underlying reason for this. The decrease of the estrogen level diminishes their protective function. Studies show that women who have had early menopause or have had their ovaries removed before the age of 40 are at a higher risk of heart disease.
After the menopause many women experience additional changes like: increased blood pressure, cholesterol and triglycerides level that are powerful risk factors.

Sex/Gender Differences in Cardiovascular Diseases
The lack of awareness about heart diseases in women can lead to belated heart attack diagnosis and late doctor’s assistance. In addition, most of the classical symptoms for cardiovascular diseases rely on studies carried out mainly among the male population. Thus, it is generally accepted that chest pain is a classical simptom for heart attack. Nevertheless, women often experience untypical symptoms like chest discomfort or pressure. Some of the other symptoms are: unusual tiredness, fatigue, shortness of breath, pain in the neck, jaw, dizziness, nausea, or some may not have any symptoms at all. What is more, as many as 60% of the women who die of heart attack do not have any previous symptoms.
These physiological differences can end in belated diagnosis and untimely treatment. Men develop stenosis of the major blood vessels more frequently, whereas women suffer diseases of the small blood vessels of the heart (microvascular disease), which makes the treatment rather challenging. Most studies show that fewer women approach to life-saving procedures like cardiac catheterization, even much later during a heart attack than men.

Prevention is the key to a healthy woman’s heart
1. Become aware of your own risk factors: increased blood pressure, increased lipids and sugar level in the blood, obesity, smoking etc. These are all modifying risk factors and it is your decision whether you treat them in order to avoid the risk of cardiovascular diseases. Factors that you cannot influence are: family history (cardiovascular diseases in the family) and ageing, but the control over the modifying risk factors definitely reduces the risk of cardiovascular diseases.

2. Treat disorders like high blood pressure, diabetes and high cholesterol levels. Consult a professional to get the best possible medical treatment.

3. Exercise regularly and maintain healthy body weight. It is not an issue even if you do not like sports. Simple walking would be enough, though vigorous walking would be the perfect choice.

4. Eat healthy food for the heart. For example, you can consume whole grains, hulls, fresh fruit and vegetables. If you are keen on meat, you can have low-fat meat prepared in a healthy way. You can also consult a doctor or nutricionist who will give you a professional advice.

5. You must stop smoking if you are a smoker! Sounds familiar, but tobacco destroys the blood vessels, they grow much older, and as they say, we are as old as our blood vessels are.

6. Make a plan and take action in time!

What should you know in order to make sure you get the best possible care?
Everyone, regardless of the age and the medical history should have routine check ups, especially after the age of 40, monitor the blood pressure from time to time, have preventive blood and urine tests, especially for the lipids and sugar levels, kidney function etc. During the doctor’s checkup talk to your doctor about the benefit and the risks of the therapy. Finally, everyone, especially women, should be familiar with and aware of the signs and symptoms for cardiovascular diseases.

Dr. Maja Vrchakovska, specialist-internist, subspecialist-cardiologist