February is American Heart Month so I want to talk about the unique differences between the hearts of men and women. A woman’s heart is different. Let’s start with some statistics….Twice as many women die from heart attacks as men. Someone dies every 37 seconds in the United States. To give you a better perspective…1 in 2 women will be diagnosed with heart disease and 1 in 5 will die of heart disease. In comparison, 1 in 8 women will be diagnosed with breast cancer and 1 in 31 will die of breast cancer. Heart disease is the leading cause of mortality in women in the U.S., more than all other cancers together. About 80% of cardiovascular disease and stroke can be prevented by lifestyle changes and education.
Women have more non-ST elevation changes on an EKG than men which means their symptoms are unlike what men experience. Women present with atypical chest pain, shortness of breath, extreme fatigue, weakness, nausea, heartburn, anxiety and a feeling of apprehension and impending doom. This is especially true of African American women. They rarely have chest pain at all, but they do have shortness of breath and weakness with dizziness. Black women have a higher prevalence of MI (myocardial infarction) than in all other racial and ethnic groups of women. They have the highest incidence of sudden cardiac death as their first manifestation of coronary artery disease.
64% of women who die suddenly of coronary heart disease have no previous symptoms.
Women also have smaller vessels known as microvascular coronary disease. These smaller vessels have a more difficult time perfusing the heart with oxygen and tend to be too small for a procedure such as a percutaneous coronary intervention, known as inserting a stent to open the vessel. Women are more likely to have a spontaneous coronary artery dissection in which the artery wall tears without warning and allows blood to build up between the artery wall layers blocking blood flow to the heart. Women tend to have more coronary artery spasm and non-obstructive disease. Another startling statistic: 64% of women who die suddenly of coronary heart disease have no previous symptoms.
Pregnancy can also raise the risk of heart disease or stroke. Women who have high blood pressure, preeclampsia, gestational diabetes, or preterm labor have a higher risk for heart disease or stroke. Pregnancy is natures stress test on the heart!
Ninety percent of women have more than 1 risk factor. The non-modifiable risk factors are gender, age and family history.
Let’s talk about the modifiable risk factors and recommendations.
- Smoking- STOP
- Diabetes: Let’s talk diet. Be conscious of what you put in your mouth. About 70% or 3 out of 4 adults are overweight or obese. About 60% of the daily total calories consumed come from ultra-processed foods. These foods do not increase satiety so we eat more and gain more weight. They are also cheaper than whole foods so we are economically incentivized to eat unhealthy. Processed foods activate dopamine reward pathways in the brain causing addiction. Our diets are nutrient poor and caloric rich. Obesity is associated with 13 different kinds of cancers. It damages DNA. It takes 3-10 years off of our life expectancy and accelerates the aging process!! We are overfed and under nourished. This leads to poor health outcomes and run away health care costs. The bottom line: eat whole foods and avoid processed foods and soda’s. Avoid pasta’s and refined breads/ sugars and eat lean proteins and more vegetables and fruit. Healthy fats and high fiber foods are good because they help satiety and blood sugars. Limit or avoid alcohol..it is toxic to the cells…sorry.
- Physical Inactivity: get moving.. its not just about the steps. Try walking, biking, swimming or running and do it 5X/week. We loose lean muscle mass as we age so we need to do some weight resistance twice per week. That doesn’t mean heavy weights and a gym membership. You can do step-ups at home or hold a plank for 60 seconds or do some yoga postures to start. Protective effects of exercise are greater for women than for men, yet physical inactivity is the most prevalent risk factor for U.S. women.
- Get your labs checked. This includes a lipid panel, HgbA1C and fasting Insulin to detect early signs of diabetes or metabolic syndrome. Also check inflammatory markers such as a CRP, Homocysteine, ox-LDL, and Lp(a). A thyroid panel and other hormones and nutrients are also essential.
- Monitor your blood pressure. Hypertension is called the silent killer due to having no symptoms. Know your family history.
So ladies, there is alot we can do to prevent heart disease. It’s about the choices you make everyday. To reiterate what I said earlier…about 80% of cardiovascular disease and stroke can be prevented by lifestyle changes and education. Get started now!