Women more at risk of heart disease today
Heart disease is no longer exclusive to men as we now know. Women, especially urban women, are more at risk of developing heart disease today. And, a heart attack is usually more severe in women than in men.
An increasingly unhealthy lifestyle with a predominantly high trans fat, sugar and salt diet, more and more sitting, stress/depression, smoking, alcohol and cigarettes are some of the factors that have contributed to this rise in heart disease. Differences in the clinical presentation also make it difficult to establish a diagnosis in women.
· Women generally present a decade later than men and with greater risk factor burden. They are less likely than men to have typical angina. Women with new onset of chest pain are approached and diagnosed less aggressively than man in the emergency department.
· Established risk factors in women are: Presence of history of heart blockages; age over 55 years; high LDL (bad) or low HDL (good) cholesterol, diabetes, smoking, high blood pressure, peripheral artery disease or family history of heart disease.
· Risk factors, which are more potent in women than in men are: Smoking is associated with 50% of all coronary events in women; diabetes confers more prognostic information in women than in men.
· Symptoms of heart attack in women differ from those in men. Women may not know recognize these symptoms as due to a heart attack. Rather than the classical presentation of chest pain, women are more likely to have extreme fatigue, sleep disturbances, lightheadedness, nausea/vomiting, shortness of breathwith or without chest discomfort, indigestion, pain or discomfort in one or both arms, the back, neck, jaw or stomach.
· Treadmill test in women has a higher false positive rate.
· Small vessel disease is more common in women than in men.