Women & Heart Disease

1.        Is heart disease is less common in women?

             No. In fact more women die because of cardiovascular diseases

          (Heart attack & Stroke) than men. Cancer of uterus, breast, ovary etc. is perceived on major health problem for women which is actually 1/8^th of the total cardiovascular mortality in them. Initial manifestation of Heart disease is generally 10 years later then men.

2.        Why Heart disease a common in women?

           Diabetes, Hypertension, Obesity, and sedentary habits are more prevalent in postmenopausal women then men. Diabetes is a stronger risk factor for Heart attack in women. Presence of Diabetes neutralizes the protective effect of premenopausal  status of younger women.

3.        Are symptoms of Heart Attack different in women?

          Yes. Atypical presentation of ‘gas’ like symptoms, heart burn, jaw pain, shoulder pain, back pain are more common them typical chest pain. They have more co morbities like associated Diabetes, Hypertension, Obesity leading to more complications of heart attack. Usually they ignore these symptoms and seek late medical attention.

4.        What are common tests women should get to diagnose Heart disease?

       Every woman should have Lipid profile test to diagnose Lipid disorder. In fact Lipid profile is            more important than Papsmear test (for cancer). ECG quite often show nonspecific changes and         is not diagnostic. However Stress Echocardiogram is better method to diagnose a patent of angina       in women compared to TMT alone.

5.    Is  angina  with  normal  coronary  artery  more  common  in 

women?

Yes. Many women with typical history of angina and positive Stress-Echo can have normal angiogram (also called as ‘Syndrome X’). This is seen in 30% of patients. They have better prognosis than patient with blocked arteries.

6.        Is  response  to  treatment  of  Heart  disease  is different  in women?

         No. Treatment for angina, Heart attack and complications of Heart attack is similar to men. However because of late presentation and more associated risk factors they have more complications and increase mortality. PTCA (ballooning & Stenting)  and Bypass surgery have same success rate but carries higher mortality because of smaller size of vessel and increased risk factors.

7.        What is the role of HRT in prevention of Heart disease in women?

     Hormone Replacement Therapy (HRT) have shown beneficial effects on lipid profile. But the              results of clinical trials (HER Study) have shown no benefit in prevention of Heart Attack. In fact       during initial 2 years it has shown increase heart attack. HRT is Contraindicated in patients with          heart attack.

8.        How women can prevent heart disease?

          Life style modification is key to success. Regular exercise, involvement in house hold work and less help from servants is important. A healthy food comprising of 2-3 servings of fruits & vegetables along with nuts, pulses & less consumption of dairy products (instead use Soya products) will reduce heart disease. Use of oil rich in monounsaturated fats (MUFA) like Olive oil, rice bran oil, mustard oil & mixture of PUFA (Poly unsaturated fatty acid) like soybean oil, Sunflower oil etc. are good cooking medium. Reduction of psychosocial stress can be done by regular yoga, Pranayama and prayers. Risk factors like Blood pressure, Diabetes and Lipid disorder needs to be controlled with medicines after consulting physician.