Heart disease in women at younger age

Heart disease is no longer exclusive to men as we now know. Women, especially urban women, are more at risk of developing heart disease today. And, a heart attack is usually more severe in women than in men.An increasingly unhealthy lifestyle with a predominantly high trans fat, sugar and salt diet, more and more sitting, stress/depression, smoking and alcohol are some of the factors that have contributed to this rise in heart disease. Differences in the clinical presentation also make it difficult to establish a diagnosis in women.

• Women generally present a decade later than men and with greater risk factor burden. They are less likely than men to have typical angina. Women with new onset of chest pain are approached and diagnosed less aggressively than men in the emergency department.

• Established risk factors in women are: Presence of history of heart blockages; age over 55 years; high low-density lipoprotein (LDL) (bad) or low high-
density lipoprotein (HDL) (good) cholesterol, diabetes, smoking, high blood pressure, peripheral artery disease or family history of heart disease.

Factors that considerably enhance the risk of heart disease in women in comparison to men are: Smoking is associated with 50% of all coronary events in women; diabetes confers more prognostic information in women than in men.

Symptoms of heart attack in women differ from those in men. Women may not know or recognize these symptoms as due to a heart attack. Rather than the classical presentation of chest pain, women are more likely to have extreme fatigue, sleep disturbances, lightheadedness, nausea/ vomiting, shortness of breath with or without chest discomfort, indigestion, pain or discomfort in one or both arms, the back, neck, jaw or stomach.Treadmill test in women has a higher false positive rate.

 Women are short in height, but what is more  relevant they suffer from small vessel disease is more common in women than in men.

     

Can Women Get Heart Disease Before

I Pre-menopause?

Elder women have been at a higher risk end for developing cardiovascular diseases. It is reported that more than 75% of women aged 40-60 have one or more risk factors for CVD. Heart disease is the leading cause of death in women over age 40, especially after menopause. Up until now the notion had been that menopause is the only phase during a woman’s life cycle during which she is prone to increased risk of CVD, but now the idea is being challenged by increasing incidences of coronary heart diseases in pre-menopausal women.

Recently, evidence has emerged that even the pre­menopause phase in a woman’s life cycle is prone to developing cardiovascular complications because ot exacerbated risk factors.

Complex hormonal and physiological changes take place during the transitory phase to menopause, the perimenopause.

Estrogen and progesterone imbalance starts to set in, body lat starts getting redistributed, there are global changes in cholesterol levels and blood pressure starts to show a rise before menopause hits. It is seen that the risk factors associated with stroke and CVD increase more rapidly in the years leading up to menopause rather than afterwards. Ibis is a result of a variety of physiological changes collectively known as the metabolic syndrome. The risk factors that together constitute the metabolic syndrome are a large waistline, high levels of blood fat (triglycerides), low levels of good cholesterol, high blood pressure and high fasting blood sugar.

These changes are associated risk factors for CVD and if left unchecked, have the potential to develop into serious cardiovascular complications. This paradigm shift in the ‘at-risk’ population for heart disease is
due to modern lifestyle. In today’s age of technology and modernization, there are a plethora of comforts available, but the cost of every comfort is some or the other form of compromised health.

According to a study conducted by Harvard Medical School, the major risk factors associated with modern lifestyle are smoking, high body mass index, a sedentary lifestyle, alcohol consumption and an unhealthy diet.

“Lifestyle-related factors that increase the risk of heart disease are becoming increasingly common among girls, teenagers, and young adults. Physical activity drops sharply as girls approach teenage years and is significantly reduced by young-adulthood. Higher or lower than normal body mass index is an important determining factor for the course of cardiac complications in high risk individuals. The good news is that these hormonal and physiological changes during the pre-menopause period are reversible or in some cases, modifiable. Appropriate lifestyle changes can be incorporated to minimize the risk of developing heart disease during this period.

“The notion that young adult women need not worry about heart health until they are ‘old enough’, needs to be abolished. Women approaching menopause need to be more proactive about following a heart- healthy lifestyle in order to minimize the effect of these associated risk factors. Your lifestyle is not only your best defense against cardiovascular diseases, it's also your responsibility towards yourself and your loved ones”.