Why women are more prone to heart diseases than men

Doctors performing an open heart surgery at the Kenyatta National Hospital, 2013. /MONICAH MWANGI
Doctors performing an open heart surgery at the Kenyatta National Hospital, 2013. /MONICAH MWANGI

A woman’s essence lies in her innate ability to care, love, nurture and sacrifice for others with all her heart.

She plays an all-enveloping character of a mother, daughter, wife and sister as a friend, nurturer, guide and partner from time to time.

Emotional and vulnerable, sometimes erratic, sometimes serene, she displays a wonderful range of emotions from being patient to being extremely courageous in times of crisis.

As men and women are intertwined in the complex maze of relationships, they essentially display different emotional and psychological characteristics in nurturing, competitiveness, academic abilities, and communication skills as a result of their physical differences.

As a consequence, their bodily response to health and disease varies.

The way we live each day affects our heart. An unhealthy lifestyle can lead to a heart attack or stroke. Heart disease is the number one killer of both men and women. The well recognized male excess in coronary artery disease (CAD) has often obscured the fact that it is also the leading cause of death in women in most industrialized countries.

Women are six times as likely to die of heart disease as of breast cancer. Yet too few women, and even some doctors, fail to recognize its unique warning signs. Women account for nearly half of all heart attack deaths.

Worldwide, 8.6 million women die from heart disease each year, accounting for a third of all deaths in women!

Just like the physical, psychological and emotional differences between men and women, there are differences in how women and men respond to a heart attack. Women are less likely than men to believe they're having a heart attack and more likely to delay in seeking emergency treatment.


Women At-Risk

Numerous risk factors have been implicated in CAD. Many of these have been documented only in men and it has been suggested that the effect of risk factors may differ either qualitatively or quantitatively in women compared to men.

• 71% of women experience early warning signs of heart attack with sudden onset of extreme weakness that feels like the flu - often with no chest pain at all. Medical professionals are challenged to respond to women's milder symptoms.

• Nearly two-thirds of the deaths from heart attacks in women occur among those who have no history of chest pain.

• Smoking, diabetes and abnormal blood lipids erase a woman’s estrogen protection.

• Women who smoke risk having a heart attack 19 years earlier than non-smoking women.

• Women with hypertension experience a risk of developing Coronary artery disease 3.5 times that of females with normal blood pressure. High blood pressure is more common in women taking oral contraceptives, especially in obese women.

• Women with diabetes have more than double the risk of heart attack than non- diabetic women. Diabetes doubles the risk of a second heart attack in women but not in men. Diabetes affects many more women than men after the age of 45.

• Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (small vessel heart disease).

One challenge for women is that their heart disease symptoms can be different from symptoms in men. Fortunately, women can take steps to understand their unique symptoms of heart disease and to begin to reduce their risk of heart disease.


Warning signs of heart attack

Women don't always feel the warning signs of heart disease the same way men do. The most common symptom of a heart attack in both men and women is some type of pain, pressure or discomfort in the chest. But it's not always severe or even the most prominent symptom, particularly in women. Women are more likely than men to have signs and symptoms unrelated to chest pain, such as:

• Neck, shoulder, upper back or abdominal discomfort

• Shortness of breath

• Nausea or vomiting

• Sweating

• Lightheadedness or dizziness

• Unusual fatigue

These signs and symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks. This may be because women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease.

Many women tend to show up in emergency rooms after much heart damage has already occurred because their symptoms are not those typically associated with a heart attack.

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And men?

• Women develop heart problems later in life than men -- typically 7 or 8 years later and more likely to have chronic coexisting conditions. However, by about age 65, a woman's risk is almost the same as a man's.

• Existing heart disease is undiagnosed in half of women who have a first heart attack.

• Metabolic syndrome — a combination of fat around the abdomen, high blood pressure, high blood sugar and high triglycerides — has a greater impact on women than on men.

• Mental stress and depression affect women's hearts more than men's.

• Younger women with heart failure have worse quality of life than men and older women.

• Women wait longer than men to go to an emergency room when having a heart attack and physicians are slower to recognize the presence of heart attacks in women because “characteristic” patterns of chest pain and EKG changes are less frequently present.

• Men's plaque distributes in clumps whereas women’s distributes more evenly throughout artery walls.

• Women are more likely than men to die after a first heart attack, and for survivors, there is a higher risk of recurrent heart attacks, heart failure, or death.

• Women are two to three times as likely to die following heart bypass surgery. Younger aged women between the ages of 40-59 are up to 4 times more likely to die from heart bypass surgery than men the same age.


Health care providers need to be sensitive to gender differences in presentation, prognosis and responsiveness to treatment of CAD.

The prognosis of women with CAD differs according to age, mode of presentation, accuracy of diagnosis, and number of risk factors and is generally more ominous in women.

The failure to treat women as vigorously as men contributes to their worse outcome although the gap is narrowing rapidly in western countries.

Doctors need to understand the risk as well as risk factors of CAD in women and the importance of prevention, diagnosis and timely intervention.

Most of the modifiable risk factors such as obesity, smoking, hypertension, diabetes and dyslipidemia are the same in both sexes and should be identified and treated early. Reducing saturated fat in the diet and simultaneously increasing the consumption of fish, fruits, vegetables, nuts and fiber are the dietary ingredients for a healthy heart.

Women-Nature your heart as you nature your family. Do not think twice because it is your own health.

Go for regular health check up do not skip meals, have timely food nourish yourself with balanced diet and practice yoga to relieve stress.

In short, prevention, early detection, accurate diagnosis and proper treatment is the key for woman’s heart disease. This helps in preserving the energy and passion of womanhood making her an elixir of life!

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