Heart health: is it different for women?

Heart health is the blanket name given to cardiovascular disease, a term that covers a wide range of conditions including heart disease, stroke and genetic heart problems.

What is the risk?

Did you know that heart disease is the leading cause of death in women? Year-on-year, it is responsible for many more deaths than breast cancer, though this is considered as a 'more serious' condition.

Stereotypically, heart health conditions have been associated with unfit and overweight men, but the reality is that that more women are suffering from cardiovascular problems than men.

According to the British Heart Foundation, more than 700,000 women in the UK aged 16 - 44 are living with heart disease, compared to 570,000 men. It is thought that this is because women are more likely to develop rarer forms of heart disease than men.

Recognising the symptoms

The symptoms of heart disease are different in women than in men, though it is not fully understood why. As a result, heart disease can often be misdiagnosed. Diagnosis by techniques such as angiography and angioplasty, for example, as well as by bypass surgery, can be more difficult to do in women as they have smaller and lighter arteries than men.

Because of this, it is very important to be aware of the different symptoms associated with cardiovascular disease in women, which differ from those of men.

For example, research published in the journal Circulation showed that most women (70 per cent) did not list chest pain as a commonly experienced symptom, though 80 per cent of women had experienced one or more symptoms a month before the heart attack.

Heart attack symptoms in men vs women: what is the difference?

Heart attack symptoms in men:

• Chronic chest pain that may come and go, or be constant and intense
• Irregular or rapid heart beat
• Shortness of breath
• Dizziness
• Breaking out in cold sweats
• Indigestion-like feeling and stomach discomfort

Heart attack symptoms in women:

• Unusual fatigue for several days or a sudden, severe fatigue
• Anxiety and sleep disturbances
• Light headedness and/or shortness of breath
• Indigestion-type pain
• Upper-back or shoulder pain with possible throat pain
• Jaw pain or pain that spreads up to the jaw
• Pressure or pain that spreads up to the jaw
• Pressure or pain in the centre of the chest that may spread to the arm

Key risk factors for heart disease

Although the risk factors for heart disease are the same in men and women, the level of risk for some is greater in women than men.

Risk factors for men and women include:

• Smoking
• High blood cholesterol
• High blood pressure
• Physical inactivity
• Being overweight or obese
• Having diabetes
• Family history of CHD or stroke
• Sex (men are more likely to develop CHD earlier than women)
• Ethnicity

While all risk factors for heart disease are serious, the following pose a more serious risk in women:

High cholesterol

Cholesterol is a type of fat (lipid). There are two kinds of cholesterol: 'bad' LDL cholesterol, and 'good' HDL cholesterol. Bad LDL cholesterol has been linked to heart disease as it can clog your arteries and reduce blood flow.

Oestrogen is a natural hormone that helps to protect women from heart disease by increasing HDL cholesterol levels and reducing LDL cholesterol levels. This means that after the menopause, where a women's natural oestrogen levels drop, women are more likely to develop heart disease.

Diabetes

Women with diabetes often have added risk factors for heart disease, including obesity, hypertension (high blood pressure) and high cholesterol. Having diabetes decreases the 10-year advantage a woman may have over a man in the development of heart disease.

Diabetes also doubles the chance of having a second heart attack and increases the risk of heart failure in women who have already had a heart attack.

Metabolic syndrome

Metabolic syndrome is the name given to a group of health risks that increase your chances of developing heart disease, stroke and diabetes. These include; large waist size, high blood pressure, high blood sugar levels and high cholesterol. It appears, in women, that metabolic syndrome is one of the most important risk factors for having a heart attack at an early age.

Smoking

Smoking is one of the main risk factors in the development of coronary heart disease. Female smokers are twice as likely to have a heart attack than male smokers. Women are also less likely to succeed in quitting smoking, and are more likely to start again than men. It is thought that this is because nicotine replacement may not be as effective in women because of the effect of the menstrual cycle on tobacco withdrawal symptoms.

9 ways to reduce your risk of heart disease if you're a woman:

1. Get your cholesterol and blood pressure checked regularly - visit your GP
2. Stop smoking - visit www.nhs.uk/livewell/smoking for advice on how to quit
3. Do more exercise - at least 150 minutes of activity (such as cycling or fast walking) every week
4. Lose weight if you need to - six in every ten women in England are either overweight or obese
5. Reduce your waist size - aim for a waistline of less than 80cm (31.5 inches)
6. Drink in moderation - drinking more alcohol than advised will increase your risk of heart problems
7. Balance your diet - be careful to moderate salt, sugar and saturated fat intake
8. Don't rely on HRT - research suggests that HRT isn't heart protective and there are side effects
9. Manage your stress levels - studies suggest that stress can contribute to heart disease