Though more than three-quarters of heart related deaths are preventable, heart disease remains the number one killer of men and women in the United States. For women, the statistics are particularly grim: Every 80 seconds a woman dies from heart disease and yet women generally do not perceive heart disease to be a top health concern. Approximately 610,000 people die due to heart disease annually in the U.S. according to the Centers for Disease Control and Prevention (CDC). That means one in four deaths occur due to heart disease across the board. One in three women are affected by heart disease over one in eight affected by breast cancer comparatively.
Is there a gender bias when it comes to recognizing and treating women for cardiovascular disease? Quite possibly. For decades medical professionals have taken what Dr. Nanette Wenger coined in the 1990s as a “bikini approach” to women’s healthcare with an emphasis on breast and cervical cancer screenings, reproductive and maternal-fetal health.
From a physiological standpoint, women typically have smaller hearts and blood vessels than men. As a result, women often experience greater complications including increased bleeding during a heart attack and accompanying surgical procedure. Physicians may be less likely to treat a women’s heart condition or cardiac event as aggressively as in the case of a man’s due to the threat of these complications.
The reality is that heart attack death rates among women exceed those among men. Culturally, women and men are often treated differently based on misconceptions about heart disease, as well as societal norms regarding gender roles. Many women face demands at work and on the home front as both financial contributors and caregivers for their families. The constant pressure and stress involved in maintaining a career and household increase the amount of cortisol produced in the body. According to The Huffington Post:
“When you stew on a problem, the body continuously releases cortisol, and chronic elevated levels can lead to serious issues. Too much cortisol can suppress the immune system, increase blood pressure and sugar, decrease libido, produce acne, contribute to obesity and more.”
Cortisol and certain other hormones circulating through the body can contribute to inflammation. Harvard Medical School’s Harvard Health Publications cites:
“Chronic low-grade inflammation is intimately involved in all stages of atherosclerosis, the process that leads to cholesterol-clogged arteries. This means that inflammation sets the stage for heart attacks.”
According to the American Heart Association:
“Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can stop the blood flow. This can cause a heart attack or stroke. A heart attack occurs when the blood flow to a part of the heart is blocked by a blood clot.”
High blood pressure and cholesterol, as well as smoking, are risk factors for heart disease. While young, menstruating women tend to maintain more normal cholesterol levels due to estrogen, post menopause, that protection diminishes and women are at a greater risk for heart disease and heart attacks. According to the CDC, “about half of Americans (47 percent) have at least one of these three risk factors,” 80 percent of all women experience at least one risk factor for heart disease and today nearly 44 million women in the U.S. live with a form of heart disease. Other risk factors include diabetes, obesity, poor diet, sedentary lifestyle, alcohol abuse and more.
— JohnsHopkinsMedicine (@HopkinsMedicine) February 12, 2016
According to the CDC, “almost two-thirds (64 percent) of women who die suddenly of coronary heart disease have no previous symptoms.” Although the majority of women experience typical heart attack symptoms like chest pain or pressure, tightening in the chest, shortness of breath and shooting pains, some women experience cardiac symptoms differently than men. Approximately one-third of women experience more subtle signs like waves of nausea or heartburn; isolated pain in the jaw, neck, shoulders, abdomen or back, or even excessive fatigue. Symptoms may come on during periods of rest or physical activity and stress can exacerbate these conditions.
Remaining active and eating a diet featuring fruits, vegetables and whole grains not only improve overall health, but heart health as well. It’s also important to limit alcohol intake, quit smoking, find constructive outlets for stress management and regularly check blood pressure and cholesterol.
February marks American Heart Month, and medical practitioners and women across the country are creating a buzz around the Go Red for Women awareness campaign, which draws attention to heart disease, warning signs and preventative care with a special focus on women sharing their stories and taking a stand.
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