Heart disease is not a men’s disease. On average, a woman dies of coronary heart disease (disease in the heart’s main blood vessels) every 80 minutes in Australia, according to the Heart Foundation.
Here, these experts take us straight to the facts, explaining what women need to know about heart health and ways they can protect their ticker.
Professor Garry Jennings, cardiologist and interim CEO of the Heart Foundation, says it’s important women are aware of the possible symptoms of heart problems.
We hear a lot about women having different warning signs of heart attacks [compared to men] but that might be overstated. Two thirds [of women] have crushing chest pain."Prof Garry Jennings, cardiologist and interim CEO, Heart Foundation
“Some women do experience non-chest pain signs and they might dismiss them as something else. It could be shoulder or neck pain, dizziness, breathlessness or palpitations [feelings of having a fast-beating, fluttering or pounding heart].”
According to Julie Anne Mitchell, the Heart Foundation’s Director of Health Strategy, the important thing is to take note and act fast. In a situation where someone is having a heart attack, women are less likely than men to dial 000. It is important you do. Advice on what to do next starts there.
When it comes to heart health, knowledge is power, so be sure you know the symptoms of a heart attack and don’t simply assume it’s something else that can be ignored. Read more.
Research shows that when it comes to heart health, women are sometimes poorly served, not just by people in the health system, but by themselves too.
“The male stereotype of heart disease is so strong that when women present to hospitals for treatment, non-chest pain symptoms like nausea, back pain, feelings of dread, can sometimes be attributed to menopause, anxiety, or a bad case of indigestion before a heart attack is even considered,” explains Ms Mitchell.
“There is even data to suggest there are actual time delays in diagnostic testing of women for heart attacks compared to men.”
On discharge from hospital, women are less likely to attend cardiac rehabilitation, less likely to take the medication they’ve been prescribed, and less likely to make the lifestyle changes they’ve been advised to adopt.
After a heart event, women want to get back to their families to reassure everyone that they are fine and there’s nothing to worry about. Yet too often their altruistic [unselfish] instincts are putting them at future risk."Julie Anne Mitchell, Director of Health Strategy, Heart Foundation
The take-home advice for women is to put your health first, know your risk of heart disease and communicate this to your healthcare team in an emergency. If you are diagnosed with heart disease, ensure you follow all the recommended advice and treatment plans to keep yourself, and your heart, as healthy as possible.
Women who live in rural, regional and remote areas of Australia can also be disadvantaged on the heart health front. “Limited access to services, to pharmacies, to outpatient clinics, the cost of ongoing medication, or perhaps because they are prioritising the welfare of other members in the family can all have an effect,” says Ms Mitchell.
The key takeaway is that good heart health is as relevant to women as it is men, says Ms Mitchell. “This isn’t something you wait until the age of 75 to worry about. Across a woman’s life, there are key moments that are significant.”
Pregnancy is one of those moments. Women who have had blood vessel complications in pregnancy (such as preeclampsia) may be at slightly higher risk of cardiovascular disease, so require closer monitoring. Women with gestational diabetes – diabetes diagnosed during pregnancy – should be tested after pregnancy to ensure their blood sugars are back in the normal range.
According to the Heart Foundation, people with diabetes are up to four times more likely to have a heart attack or stroke. Plus, almost a third of all deaths in people with diabetes are due to cardiovascular disease. Over time, high blood sugar levels from diabetes can damage blood vessels in the heart and make them more likely to develop fatty deposits. The longer you have diabetes, the higher the chances that you will develop heart disease.
Menopause is another significant moment for women’s heart health, when heart disease rates begin to climb. One reason this occurs is because oestrogen, which has a protective effect on the cardiovascular system, drops in the lead up to menopause and does not recover.
“MHT (menopausal hormone therapy) can be useful to treat troublesome menopausal symptoms, and there is also evidence to suggest that it provides some protection against heart disease,” says Jean Hailes endocrinologist Dr Sonia Davison. “However, it’s important to have a discussion with your doctor about the benefits and risks of MHT as it differs for every woman.”
She adds that the role of MHT is vital for women who go through premature or early menopause (that is, menopause before the age of 45) to decrease this risk of heart disease. Read more about MHT.
If you’re aged 45 or over, it’s important to have annual heart health checks with your doctor. Because Aboriginal and Torres Strait Islander women have a higher risk of heart disease, regular heart health checks for these women begin at the age of 30. A yearly heart health check is covered by Medicare.
The doctor will take your family and medical history, including your experience during pregnancy, whether you had complications, and whether you had an early menopause. The doctor will also assess your lifestyle risk factors – such as whether you smoke, are physically active, and eat a healthy diet – perform a blood test to look at your cholesterol and blood sugar levels, and take your blood pressure.
That information will determine if you are at low, medium, or high risk of having a heart attack or stroke in the next five years. Your GP will then discuss a plan to reduce that risk with you.
Good heart health is about the choices you make every day. Forget the fads and the trends. If you get the basics right – eating and sleeping well, exercising regularly, and having regular heart health checks – your healthy heart will follow.
While there’s huge benefit in healthy nutrition, there’s no superfood, nothing magical in any particular food, says Professor Jennings. “It’s the balance of nutrition that’s important and plenty of fresh fruit and vegetables. A low-fat and balanced meal is much better than anything that comes in a pill or a cream.”
Ms Mitchell urges women to walk for at least 30 minutes a day. “We know that walking is the cheapest and easiest form of exercise anyone can do,” she says. “What’s good for your heart health is also good for mental health.”