If women are asked, what is the biggest threat for your health, I am sure most will not name heart disease. So let’s bust 10 myths about heart disease in women..
Myth 1– Heart disease is not a major killer in women.
Facts-
Coronary artery disease is the leading cause of death for women.
Kills 1 out of every 3 women.
Globally, 1 out of 4 women dies of heart failure.
One woman dies every minute from cardiovascular disease in the U.S.!
Myth 2- But isn’t it Breast Cancer that women need to worry about the most?
Facts-
•Nearly twice as many women in the United States die from cardiovascular diseases as from all forms of cancer.
•Cardiovascular disease kills six times as many women as breast cancer.
•Stats-
Myth 3- More men die of cardiovascular disease than women.
Fact-
• Each year more women die of heart disease than men.
- Let’s look at the trends in the US- We shouldn’t be surprised if a similar graph will follow in India as well.
Myth 4- All women are protected from heart disease.
Fact- Conventional Risk Factors in Women
•Age- After menopause
•Women who smoke- 6x increased risk of MI (vs. 3x in men)
•Women with diabetes- 2x the risk of fatal CAD
•Hypertension- More common in women with CAD than men.
•Dyslipidemia- Females have higher prevalence of lipid abnormalities than men
•Metabolic Syndrome- More common in women
Risk factors exclusive to women-
•Use of Contraceptive Pills/Hormone therapy- Some forms may increase heart disease
•Pregnancy induced hypertension/diabetes
Myth 5- Young women do not need to worry
Fact-
•Atherosclerosis begins from 2 years of age- Unhealthy diet and lifestyle patterns start at young age
•Young age is the vulnerable age to start smoking and in women, frequently coexists with use of OC pills
•Higher stress levels
•Women in this age group are highly focused on caring for their families and have to also juggle time with their careers.
•Pregnancy related complications as discussed
•Family history of heart disease can give rise to heart issues even in younger women
Myth 6- All forms of heart disease are more common in men
Fact- A large subset of heart diseases are much more common in women than men
•Sudden Cardiac death
•Heart Failure with preserved EF (HFpEF)
•Women’s ischemic heart disease (syndrome X, microvascular disease/ MINOCA)…
•Myocarditis
•Stress-induced cardiomyopathy/ Peripartum cardiomyopathy
•Coronary dissection
•Cancer and heart- Chemotherapy or Radiation induced abnormalities in pumping of the heart
Myth 7- Heart disease will present in the same way in men and women.
Fact-
•Heart attacks without chest pain happen more commonly in women than men.
•43% of women have no chest pain during heart attack
•Breathlessness, Acidity, Fatigue, Pain in back/arm may be their complaints
Myth 8- Women with heart disease fare better
Facts-
•38% of women with heart attack die within a year compared to 25% of men
•35% of women heart attack survivors have another heart attack compared to 18% of men
•Women are almost 2x as likely as men to die after bypass surgery
•Women are roughly 10 yrs older than men when they present, and have more co-morbidities
•Women with MI are more likely to have complications
•Higher in-hospital mortality in women (14.6%) than in men (10.3%)
•Young women who develop CAD have a worse outcome than same age men
Myth 9- Diagnosis and treatment of heart disease is similar in both sexes
Fact- Unique challenges exist in management of heart disease in women
•Baseline ECG in women often shows T wave and q wave abnormalities- Makes interpretation difficult in the presence of atypical symptoms
•Treadmill Test is often falsely positive or limited due to inadequate exercise tolerance
•Perfusion scans and CT coronary angiograms have radiation exposure- Caution in childbearing age
•Smaller arteries in women makes interventions more challenging
•Higher rates of bleeding
Myth 10- There must be gender equality in healthcare
Fact-
•Women receive Fewer cholesterol screenings
•Fewer lipid-lowering therapies
•Less use of heparin, beta blockers and aspirin during heart attack
•Fewer referrals to cardiac rehabilitation
•Women receive only 33% of all angioplasties and bypass surgeries
•28% of implantable defibrillators
•Poor representation in most trials and studies conducted in heart disease
Solutions??
•Awareness is the key- In patients as well as doctors
•Need for routine screening and emphasis on physical fitness is as important in young women as in men
•Aggressive management of risk factors- irrespective of gender
•Gender equality in research and treatment
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