Heart disease is the leading cause of death for women worldwide, but it remains undiagnosed and untreated, according to a leading cardiologist.
For Dr. Susan Connolly, a consultant at Galway University Hospital, it is crucial that women are made aware of the risks posed by heart disease, and the perception that it is primarily a male disease must be eradicated.
The risk begins to increase, due to hormonal changes, at the time of menopause, the time in a woman’s life when she stops menstruating, says this cardiologist.
“Before menopause, women’s risk of heart disease is much lower than men’s, but then it recovers quickly and is thought to be due to a decrease in estrogen, which is actually a heart-protective hormone,” she explains.
Estrogens are a group of hormones that play a key role in female reproductive health, including puberty, menstruation, pregnancy and menopause. They are also important for heart, bone and brain health in both men and women, according to the U.S. National Library of Medicine (NLM).
For Dr. Sandra McNeill, a gynecologist specializing in cardiovascular diseases, it is important for women to be in the best possible health when they reach menopause.
This includes not smoking, watching their weight, drinking alcohol and exercising.
“Traditionally, it was thought that heart problems were only suffered by men. Unfortunately, that is not true. Women are protected to some extent until menopause by estrogen,” says the gynecologist.
However, once this stage of a woman’s life is reached and estrogen levels drop, the heart suffers and, according to McNeill, heart problems outnumber those suffered by men.
Due to the positive effect of estrogen, women generally develop heart disease 10 years later than men.
If menopause occurs before the age of 40, the risk of heart disease is higher than in other women of the same age.
Different symptoms
“We may not have the same symptoms as men, the classic symptoms we’ve been taught in medical school. But postmenopausal women have a higher risk of cardiovascular disease than men, and cardiovascular disease in postmenopausal women is the leading cause of death,” warns gynecologist McNeill.
These “classic” symptoms are often chest tightness, arm pain and shortness of breath, which women with heart disease may also experience. But they are not the only ones. Women may also report other symptoms, such as nausea, fatigue, indigestion, anxiety and dizziness.
“Women tend to present later (at the hospital) because they don’t realize they’re having a heart attack, they don’t see themselves at risk,” Connolly argues.
Recognizing and treating a heart attack quickly improves the chances of survival.
Women are often not diagnosed as quickly as men.
This is because, among other things, women are more likely to have “silent” heart disease, i.e., without symptoms, or because health professionals sometimes fail to recognize the disease because the symptoms are different from those of men.
Women are also more likely to suffer from certain heart diseases that are more difficult to diagnose, such as microvascular coronary artery disease, broken heart syndrome, or variant angina, the NLM explains.
A delay in diagnosis could lead to a delay in health care that could help prevent serious illness such as a heart attack.
“It’s the biggest killer of women worldwide,” says the cardiologist. “Twice as many women die from heart disease as from breast cancer, so it’s crucial for women to be aware of their risk, which starts to increase around the time of menopause.”
In addition to taking care of their physical and mental health, women who want to take care of their heart are also advised to watch their cholesterol levels.
*Reported by Marie-Louise Connolly and Catherine Smyth, BBC News Northern Ireland.