Coronary artery disease is the leading cause of death in both men and women worldwide.
Clogging of the arteries occurs as a result of smoking, high cholesterol levels, high blood pressure and diabetes. Genetics also play an important role. Obesity, leading a sedentary lifestyle and stress are important risk factors for the development of the disease.
Narrowing of the coronary arteries may eventually cause heart attacks, when there is complete occlusion of the artery supplying blood to the heart muscle. It can also eventually lead to heart failure, when the muscle of the heart is so damaged that the heart cannot keep up with its pumping function.
We have come a long way since the days when a woman’s worry over heart disease centred exclusively on its threat to the men in her life. We now know it is not just a man’s problem. Every year, coronary heart disease, the single biggest cause of death in the United States, claims women and men in nearly equal numbers.
Many may be surprised to learn that women die more of heart disease than of breast cancer. It is actually more deadly than all forms of cancer combined.
While breast cancer causes one in 31 American women to die each year, coronary artery disease is the cause of death in one in 8.3 American women.
Malta is no exception. Cardiovascular diseases in Malta remain the leading cause of death for both men and women. They are responsible for 41 per cent of deaths in women and 35 per cent of deaths in men. In contrast, deaths from cancer account for 24 per cent of all deaths in women and 34 per cent of all deaths in men.
Moreover, more than a quarter of all deaths from narrowing in the arteries of the heart are premature, occurring in people aged under 75.
Heart disease affects women of all ages. For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 per cent. And while the risks do increase with age, things like overeating and a sedentary lifestyle can cause narrowing of the arteries later in life.
Heart disease in women tends to show up at an older age (on average, a woman’s first heart attack occurs at the age of 70), so the threat may not seem all that real to younger women. Most 50-year-old women know women their age who have breast cancer but none who have heart disease.
Unfortunately, 64 per cent of women who die suddenly of coronary heart disease have no previous symptoms. Because symptoms of heart disease vary greatly between men and women, they are often misinterpreted.
Many may be surprised to learn that women die more of heart disease than of breast cancer. It is actually more deadly than all forms of cancer combined
The media has conditioned us to believe that the telltale sign of a heart attack is a crushing chest pain – classic of heart attacks in men. But in reality, women are somewhat more likely to experience shortness of breath, nausea, vomiting and back or jaw pain. Other symptoms women should look out for are dizziness, feeling light-headed or fainting, pain in the lower chest or upper abdomen and extreme fatigue. During a heart attack, only about one in eight women report chest pain, and even then, they describe it as pressure, aching or tightness rather than pain.
Unfortunately, women are much more likely than men to die within a year of having a heart attack. Women also do not seem to fare as well as men do after taking clot-dissolving drugs or undergoing certain heart-related medical procedures.
Women have smaller and lighter coronary arteries than men. This makes angiography, stent deployment and coronary bypass surgery more difficult, thereby reducing a woman’s chance of receiving a proper diagnosis and having a good outcome. Women also tend to have more complications following surgery.
Fortunately, these problems are diminishing thanks to advances in technology and better understanding of heart disease in women. Research is only now beginning to uncover the biological, medical and social bases for these differences. The hope is that new knowledge will lead to advances in tailoring prevention and treatment to women.
Even if one is a yoga-loving, marathon-running workout enthusiast, the risk for heart disease is not completely eliminated. Factors like cholesterol, eating habits and smoking can counterbalance other healthy habits.
One can be thin and still have high cholesterol. It is recommended to start getting one’s cholesterol checked at the age of 20, or earlier if there is a family history of heart disease. One must also keep an eye on blood pressure as hypertension is often silent.
It is important to implement an action plan to keep your heart healthy.
Do not smoke, actively or passively. The chance of having a heart attack doubles if one smokes as few as one to four cigarettes a day. Even if a person does not smoke, regular exposure to someone else’s smoke can increase the risk.
Be more active. It is recommended to get at least 30 minutes a day of moderate-intensity exercise, such as brisk walking. Fitting even more activity into one’s life, like taking the stairs rather than the elevator, and parking farther away from one’s place of work, increases the opportunities to walk more.
Eat healthily. Studies have identified several crucial ingredients of a heart-healthy diet – whole grains, a variety of fruits and vegetables, nuts, poly- and monounsaturated fats, oily fish, and limited intake of trans fats.
Reduce stress and treat depression. The risk for heart disease increases if one is depressed or feeling chronically stressed. Stress-reducing strategies include exercise, adequate sleep and relaxation techniques.
Most of the risk factors for developing heart disease are preventable or can be controlled. So ladies, take care of your heart. Prevention is better than cure.
Mariosa Xuereb is consultant cardiologist at Mater Dei Hospital. She is the first female cardiologist in Malta.