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 Women's Health

october 2012

Neglect Gives Heart Ache To Women

Dr P K Sahoo
World Heart Day observed recently, sought to draw our attention to cardiovascular disease prevention among women and children. It was also something about clearing the still pervading myth that cardiovascular diseases (CVD), including heart attacks and stroke, are lifestyle diseases that mostly affect the male population and the older and affluent men.
How Common Is Heart Disease In Indian Women?
The overall rate of heart disease among women in India is nearly as high as in men, despite the difference in the number of smokers between the two.

The fall in the mortality rate from heart attacks remains slower or markedly lesser in India than the West. This difference in mortality rate has only increased in the last 30 years.

Angiographic studies in Indian women have shown high prevalence of severe and extensive disease, including threevessel disease (40 per cent), despite the fact that more than half of these women were premenopausal.

Women And Risk Factors For Heart Attacks

The risk factors for cardiovascular disease (CVD) are the same for both genders but significant changes occur in women after menopause. Estimates suggest that 70 per cent of deaths are attributed to modifiable risk factors.
  • Young women are normally at very low risk of CVD. Things turn risky for them when they take to smoking or suffer from high blood pressure, diabetes and high cholesterol levels or have a family history of heart attacks.
  • If women take the trouble to modify their risk factors up to menopause, they can see themselves in very low lifetime risk for heart attacks and enjoy markedly longer survival.
  • High blood pressure, a significant risk factor for the development of heart disease, is rare among young women, but it increases after menopause. Women with high blood pressure are at 3.5 times the risk of developing heart attacks compared to that of women with normal blood pressure.
  • After menopause, women’s cholesterol levels are on average higher than those of men of about the same age. After the age of 60, women’s blood pressure also is on average higher than men.
  • An obese woman increases her risk of dying of heart attack by 45 per cent compared to a woman of normal weight. However, maintaining normal weight will not protect the woman against heart attacks, if she is physically inactive.
  • Abdominal obesity (waist size more than 31 inches or 80 cm among women) is a stronger predictor of heart attacks. Another rule of thumb for obesity is having waist girth more than 50 per cent of the height. Even a one centimetre increase in a woman’s waist measurement increases the risk of cardiac event by two per cent.
  • Women tend to be more physically inactive than men. If a woman is physically inactive it increases the risk of heart disease by 60 per cent. Women who engage in less than an hour’s physical activity a week are at a 60 per cent higher risk of developing heart attacks.
Heart Attacks: Differences In Men & Women
  • Heart disease affects women approximately 10 years later than men, possibly due to the protective effects of oestrogen. Risk of a heart attack increases after menopause.
  • Usually women having heart attack do not experience the typical chest pain symptoms. But chest pain is more common in women and is mostly neglected.
  • Younger women who have heart attack have a higher mortality than men of the same age.
  • Women with established or suspected heart disease have lower fat deposit than men.
  • Young or middle-aged women (whom one would expect to be most advantaged for coronary disease risk), show higher rates of adverse outcomes, complications, and disability after heart attacks, as compared to men.
  • Smoking is a major risk factor for heart attacks with double the risk among smoking women. Exposure to second hand smoke increases their risk of dying from heart disease by 15 per cent.
  • Women who use new generation oral contraceptives do not have an increased risk of heart attack but when combined with cardiac risk factors such as high blood pressure, obesity and smoking, the risk of heart attack increases.
  • Women with depression or diabetes have double the chances of heart attacks and death, which increases by five-fold when both are present.
  • Women who have had gestational diabetes, recurrent miscarriages, pregnancy induced hypertension or preeclampsia, have a higher risk of having a heart attack at a younger age than those who have not.
Activate Your Heart!
  • Grab a walking partner. Find a friend to join you in becoming more active. Exercising together will provide you both with support and encouragement to stick with exercising when you get tired or discouraged.
  • Walk every day. Start small with a short walk and gradually build up to at least 30 minutes or more each day. Or you can take several short span walks every day. Walking with a friend or partner will make your walks even more enjoyable.
  • Move more often. When watching television, get up and walk around or march in place during commercials. Try hiding your remote and get up every time you want to change the channel. At work hand deliver messages to colleagues instead of using the telephone or E-mail. If you’re on the phone, get up and walk around.
  • Dance when listening to music!
  • Take the stairs. Try taking the steps down and several flights up, instead of the elevator.
  • Ditch the car. Park your car several blocks away from your destination. If you use public transport, get off before your stop and walk the rest of the way.
  • Plan in advance. Include activities such as walking, golfing, hiking, bicycling, skating, or swimming in your vacation plans.
  • Maintain good hydration. Be sure to drink lots of water before, during, and after you exercise.
  • Try different new activities. Try several kinds of exercise and find ones that you really enjoy.
  • Beware: Before you start exercising, talk with your doctor to see if you should take any precautions.
Dr P K Sahoo is Senior Consultant Interventional Cardiologist, Apollo Hospitals, Bhubaneshwar