What does someone with heart disease look like? A stressed out CEO? A smoker over 50? Whatever image came to your mind, chances are it was of a male. We tend to think of heart disease as a male problem, but did you know that heart disease is now the leading cause of female deaths worldwide? Yet up until recently, two-thirds of all heart health research has focussed exclusively on men.
If you’re a woman at risk of cardiovascular disease (CVD) there is good news – researchers are working hard to close the gender gap and prioritize female-based cardiac research. Let’s see what they are teaching us about female-specific heart disease factors and how you can reduce your risk.
What the Gender Gap Means for Women’s Heart Health
Women’s Bodies Are Different
Specifically, women’s hearts and arteries tend to be physically smaller than men’s. And since plaque build-up in our arteries is a key factor in all heart disease, smaller arteries mean they are at risk of becoming clogged faster in women.
Different Plaque Deposits
It’s not just anatomical differences – the way that arterial plaques and injuries show up in women can be very different from men, delaying a heart disease diagnosis or even leading to a misdiagnosis. This may go some way to explaining why more women who have heart attacks die compared to men, and why women are more likely to have second heart attacks.
Dismissive Diagnosis
Heart attack symptoms often look different in women. For example, the sharp chest pains of angina precede a heart attack in everyone, but women may have additional symptoms such as extreme fatigue, trouble breathing, and pain across the stomach and upper back. Not recognizing these additional red flags can lead to a dangerously delayed or incorrect diagnosis.
The research tells a troubling story around diagnosis – when female patients report stress alongside recognized heart disease symptoms, they are significantly more likely than men to be given a diagnosis of anxiety. Even when the same heart-related symptoms were reported.
Less Risk Factor Screening
But almost the exact opposite is also true. After receiving a heart disease diagnosis, women are not screened as often as men for depression. However, research tells us that depression is a key heart disease risk factor, and strikes almost twice as many female heart disease sufferers than male. This crucial gap can increase womens’ risk for subsequent fatal heart attacks, and slow down recovery.
Different Hearts, Different Diseases
The term ‘heart disease’ or ‘cardiovascular disease’ goes way beyond heart attacks, and includes a host of different issues affecting the heart, blood vessels and arteries. Not surprisingly, some heart conditions affect more women than men. For example, 90% of all
Spontaneous Coronary Artery Dissection (SCAD) patients are women, and it accounts for 25% of all heart attacks in women under the age of 60. If your doctor is only looking for the heart diseases factors that mainly affect men there is a real potential for late or incorrect diagnosis for female patients.
What Special Risk Factors Do Women Have?
Many of the risk factors are the same for men and women, however the potential impact they can have differs.
Obesity & Smoking
Of the many shared factors, obesity and smoking are the ones that most often impact women more than men. In one study, obesity increased the risk of heart disease by 64% in women, compared to 46% in men. In another study, female smokers had a 25% higher risk of heart disease when compared with men.
Breast Cancer Treatment
Women receiving radiation for breast cancer are particularly vulnerable, with studies showing higher rates of fatal heart disease.
Inflammation
Chronic inflammation is a factor too. Recent research shows that women who have inflammation-related health conditions are a higher risk of heart disease.
Hormones, in Particular, Estrogen
Hormones also come into play. We think of estrogen as the quintessential ‘female’ hormone that affects our periods, pregnancy, and menopause. But did you know that this hormone plays important roles in insulin sensitivity, inflammatory response and cardiovascular health?
Pregnancy
In pregnancy there are big changes in heart rate and blood pressure, which can increase the risk of a heart attack. Diabetes is also a key risk factor, and if Gestational Diabetes appears during pregnancy, the heart attack risk is increased further.
Menopause
Research shows that heart disease risk increases significantly for women significantly during menopause. It is thought that higher estrogen levels pre-menopause provide a protective heart effect, and studies also show that cholesterol levels tend to increase after menopause. Remember those smaller female arteries that can clog faster than men’s? More cholesterol means more heart disease risk.
How You can Reduce Your Heart Disease Risk
In addition to quitting smoking and reducing stress, weight management is the most effective way for women to reduce heart disease risk. Excess weight is hard on the heart, and is a stronger heart disease risk factor for women than men. Let’s look at a few easy ways to get on the path to heart health:
Get Moving
Current medical guidelines suggest that women should engage in a minimum of 2.5 to 3 hours per week of vigorous physical exercise. If that sounds like a lot, try breaking it up into exercise bites of 10 – 15 minutes each. Take a walk during work breaks, take the stairs instead of the elevator, or have a personal dance party!
Eat More Plants
You don’t have to become a vegetarian or vegan to welcome more plant foods into your life. The key is to make it enjoyable by choosing fruits and veggies that you like, and get lots of variety. Think of veggies as the main course instead of the side dish and aim to have at least 60% of your lunch and dinner plates covered with veggies. Summer is a great time to get gorgeous local produce. See what’s in season and don’t be afraid to try something new!
Eat Good Fats
When your body craves fat, it’s not actually asking for more chips. It really wants ‘good fats’ like those found in salmon, avocado, nuts and seeds. But if you don’t have these foods often, they’re not on your body’s radar. Try adding more of them to your diet, and see if you notice a change in your fat cravings. Once your body gets to know these nutrient-dense foods it will request them more often!
Women lead with the heart, make sure yours stays healthy!
Resources:
Canadian Women’s Heart Health Centre: http://cwhhc.ottawaheart.ca/
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Heart and Stroke Foundation of Canada: https://www.heartandstroke.ca/
World Health Organization: https://www.who.int/gho/women_and_health/mortality/situation_trends_causes_death/en/
