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Women and Heart Disease

Women over fifty – even slim, healthy eaters – are more likely to suffer a heart attack than get breast cancer. In this article the writer tries to finds out why:

Lynn Connor had no idea she was having a heart attack when chest pains began one sunny spring day in 2004, so she didn't call 999. Instead, her husband took her to their GP, who called an ambulance immediately. On the way to the hospital she was given clot-busting drugs and later had angioplasty and five stents inserted to prop open a single blocked artery.

"I wasn't overweight," says fifty six year old Lynn, "In fact my nickname was 'tin ribs', but although I ate healthily, I'd averaged twenty cigarettes a day for twenty years. I'd also been treated for high blood pressure, but I'd stopped the medication two years before the heart attack when the readings normalised." She also had a high blood cholesterol reading of six mmol/l (millimoles per litre of blood).

A possible contributory factor in Lynn's case was the level of pressure she had endured in previous months. "We had been to hell and back," she said. "My daughter-in-law had premature twins at twenty five weeks, so I was driving a one hundred mile round trip to the hospital every day for four months."

	Coronary Heart Disease (CHD) kills over four times more women than breast cancer does. Heart and circulatory disease is the number one killer of women, yet the myth persists that it is only overweight, middle-aged businessmen, stuffed full of corporate lunches and stress, who suffer from CHD. Although women are less at risk in earlier life, after the menopause the risks are equal. That is why the European Society of Cardiology (ESC) and the British Heart Foundation (BHF) have campaigned to raise awareness of the real risk of coronary heart disease among women. Professor Silvia Priori, chairperson of the ESC Women at Heart campaign in 2005, said, "Women think 'I can smoke or over-eat' as they have not seen their female peers having heart problems up to the age of fifty. That's because in women it strikes later, but it does strike. And then it is often after years of unhealthy living, often with insufficient exercise and an inappropriate diet. So women need to be better educated on the importance of heart-healthy lifestyles and sufficiently screened for risk factors before heart disease strikes." While the female hormone oestrogen seems to protect women before the menopause, a 2003 study by Nottingham University found no evidence that the synthetic oestrogen in Hormone Replacement Therapy (HRT) reduced the risk of heart disease. In fact some research shows it slightly increases the risk of heart attack, stroke and dangerous blood clots. So how do women reduce these risks?
Quit smoking

Women smokers have a higher risk of death from heart disease than male smokers, according to an Italian study published in 1999; it also warned that the difference is greater for heavy and long-term smokers. Whatever your sex, smoke-damaged arteries attract fatty deposits that restrict the blood flow to the heart muscle. Smoking also has the effect of making blood more sticky and likely to clot - this could lead to a blockage in an artery, which can cause a heart attack.

Exercise and Stress

	To keep your heart and circulation in good shape, be active on at least five days a week for thirty minutes, broken up into fifteen minute periods if you prefer. You need to exert yourself enough to feel warm and slightly breathless but still be capable of holding a conversation. However, if you are not accustomed to exercising regularly, consult your GP before you begin and don't try to do too much too quickly.
	Little is understood about how various kinds of stress affect the body at different ages. The symptoms include constant tiredness, tearfulness, palpitations, sleep problems or nausea. Obvious remedies include managing your time more efficiently, taking more exercise and learning stress-reduction techniques.

Vital checks

If you know you have some of the risk factors outlined above, you should ask your GP to do a few basic checks such as blood pressure, weight and tests for cholesterol and triglyceride levels. Most of all, you need to be aware that although coronary heart disease is still the UK’s single biggest killer, it is largely preventable.

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