Heart disease is a major killer. One in four women in the United States dies from heart disease.1 In fact, coronary heart disease is the leading killer of both genders in the United States.
One fact that many people don’t realize is that while the advice for living a healthy lifestyle is broadly similar for both genders, there are some differences between the genders in terms of the types of heart disease that they suffer from and the symptoms they experience. Understanding these differences is the first step towards fighting heart disease effectively.
Coronary Heart Disease vs. Coronary Microvascular Disease
Coronary heart disease (CHD) is the most well-known form of heart disease. It affects both men and women, and it can lead to angina and heart attacks, as well as heart failure, cardiac arrest, and arrhythmia. It is the most common kind of heart failure in men.
There is another form of heart disease, called coronary microvascular disease, or non-obstructive CHD. While coronary heart disease affects the larger arteries, coronary microvascular disease affects the tiny arteries in the walls of the heart. Women are more likely to suffer from coronary microvascular disease than men because the condition is thought to be worsened by the fall in estrogen levels that occurs during menopause.
At the moment, the standard tests to assess a person’s risk for heart disease test only for CHD but miss some of the signs of MVD, which means that women who attend screenings may be missing out on a full assessment of their heart health.2
Reducing Your Risk of Heart Disease
Younger women enjoy some protection against heart disease because their bodies produce more estrogen. After menopause, however, that estrogen production drops off, and a woman’s risk of heart disease increases. This is a part of the reason why women tend to be older than men when they have their first heart attack.3
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There are many factors that can affect your risk of having a heart attack. Some are common knowledge, such as smoking, obesity, and high cholesterol. There other risk factors, however, that affect only women and that may be less well-known. For example, women with endometriosis are at a significantly higher risk of developing heart disease.4 It is thought that polycystic ovary syndrome can increase the risk of heart disease as well.5
Heart disease in women is harder to diagnose, and women often require longer hospital stays after the event and find it harder to recover. A woman’s heart is smaller than a man’s and pumps less blood per beat. Therefore, it is especially important that women take good care of themselves and try to minimize the risk of developing heart disease in the first place. There are a few simple things that you can do to greatly reduce the risk of heart disease: 6
- If you are a smoker, quit as soon as possible.
- Get regular exercise. Aim for a minimum of 150–300 minutes per week, ideally more.
- Eat a diet rich in vegetables, whole grains, and fish, with minimally processed foods,
- Maintain a healthy weight and monitor your blood pressure and sugar as you get older.
Heart Health and Menopause
The largest challenges for women in terms of heart health come around menopause. Estrogen is the female sex hormone, and from puberty, up to menopause, this hormone helps the reproductive system function and also has a protective effect on the heart and blood vessels. When estrogen production falls off during menopause, the risk of cardiovascular diseases, including heart disease and strokes, increases.7
Some women who are going through menopause experience mood swings, hot flashes, night sweats, and other unpleasant symptoms, and they may ask their doctor for hormone replacement therapy (HRT) in order to ease those symptoms.
The use of HRT is still in its infancy compared to other medications, and doctors are divided as to how safe HRT is. Recent research, however, suggests that HRT will not increase the risk of dying from cardiovascular disease and that women who start HRT before the age of 60 are not at an increased risk of developing heart disease.8
Many doctors take the stance that if HRT can improve a woman’s quality of life and help prevent inactivity or unhealthy eating habits, then any marginal risk that may be associated with taking HRT could be offset by the lifestyle improvements that would come from using HRT.
Screening and Prevention for Heart Disease
When you go to the doctor, there is a good chance that they will weigh you and take your blood pressure as a matter of course. These two metrics play an important role in predicting a person’s risk of common health conditions.
If you are overweight or obese, then your doctor will recommend a sustainable weight loss plan for you. If you have high blood pressure, they will recommend diet and lifestyle changes to help manage those issues. Two important programs that women can follow include therapeutic lifestyle changes from the NHLBI and the DASH diet.9,10 Together, these changes can improve our quality of life and reduce the risk of cardiovascular disease.
Stress and Heart Disease
Studies show that stress and anxiety can be triggers for heart attacks. The medical community remains skeptical about the idea that stress actually causes heart disease, however, it is thought that in someone with heart disease, acute stress can trigger a heart attack.11,12 Therefore, it is important that individuals find ways to manage stress, whether that is through exercise, self-care, or meditation.
Studies show that some essential oils have antioxidant and cardioprotective effects. Using aromatherapy as a way of relaxing and unwinding could help reduce the risk of heart disease in the long term or at least reduce some of the stress that can exacerbate it.13
Recovering from Heart Disease
If you are diagnosed with heart disease, then your doctor will look for ways to treat the immediate risk and then prevent future cardiac incidents. Their goal will be to slow, stop, and in the best case scenario, reverse the buildup of plaques in the arteries. They may do this through medicine, surgical procedures, or lifestyle changes.
As mentioned earlier, heart disease differs between men and women. If a woman is discharged after a heart-disease-related episode but still experiences symptoms, it is worth them being vocal to their doctor and asking to be seen by someone who is experienced in treating women’s heart issues, just in case they have issues with the smaller blood vessels in the heart.
Once the initial episode has been treated, you will likely be referred to a cardiac rehabilitation program where you will be provided help to get your fitness up and restore your confidence. They will be able to advise you on any lifestyle changes that you need to make in order to stay healthy, any restrictions you may have, and how to reduce the risk of future episodes.
You may need to come back for routine assessments, have blood tests, and keep your weight within a certain range. If you have been given medication, then the doctors will want to monitor you for a while to make sure that the medication is working. You may need more frequent appointments during the early period while they try to find the right doses for you. It is important that you keep up with those appointments even if you are feeling OK at that moment in time.
One reason why women often fare poorly compared to men after a heart attack is that women are stereotypically more likely to put the needs of their family first rather than taking care of their own health. This means that they may skip certain aspects of rest, recovery, and rehabilitation.
To make the best recovery or reduce your risk of heart disease, it ‘s important that you take good care of yourself. Remember, you only have one heart, and it has to last a lifetime, so it’s important to take care of it.
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