Dr. Garima Sharma is director of Cardio-Obstetrics and director of Cardiovascular Women’s Health at Inova.
Contrary to popular belief, cardiovascular disease kills more women each year than breast cancer. In the time that it takes you to read this article about heart health, more women will have died of a heart attack than from breast cancer.
What Are the Risks?
Women face specific risk factors throughout different periods of their lives that increase their chances of developing heart disease.
Several of these are pregnancy-related risks factors:
- Preeclampsia, a condition in pregnancy characterized by high blood pressure;
- Preterm birth;
- Gestational diabetes;
- Heart disease or cardiomyopathy associated with pregnancy.
Women also are more susceptible than men to risk factors such as inflammatory disorders including lupus and rheumatoid arthritis. They face a higher risk of developing cardiovascular disease due to the following conditions:
- Endometriosis;
- Surgical menopause — menopause earlier in life because of breast cancer, or other gynecological cancers where the ovaries have been removed;
- Infertility.
Lastly, traditional risk factors, such as chronic hypertension and diabetes, impact women more severely than men. As women age, their mental health — including stress which may lead to high blood pressure — along with the transition to menopause can contribute to developing cardiovascular disease.
Potential Signs of Heart Disease
Sometimes women can experience multiple symptoms that can be misdiagnosed or overlooked. They might have chest pain, but also feel fatigued and dizzy along with pain in the neck, jaw, back, arm, and other parts of the body. If they start to feel differently than they normally do in their daily routines or when exercising, or if they notice a dull pain or pressure points in their chest, these could potentially be signs of heart disease. They should talk to a healthcare provider right away about what they’ve been feeling.
How Heart Health Affect Pregnancy
One growing area of research is heart health and pregnancy. Seven to 10 percent of the pregnancies in this country will be impacted by blood pressure disorders. This is a significant number of women so it’s important to understand who is at elevated risk and how it can be reduced. More will be learned as findings from clinical research are published.
A woman’s level of cardiovascular health is defined by these eight elements:
- Blood pressure;
- Blood glucose;
- Blood condition;
- Cholesterol level;
- Weight;
- Smoker versus non-smoker;
- Sleep patterns;
- Diet and exercise.
Once a woman is pregnant it’s important to maintain these elements within a healthy range as much as possible for both the mother and the baby. Complications can arise if the woman has had a heart attack or has existing cardiac irregularities such as valvular heart disease, heart failure, or arrhythmias.
Additional risk factors that impact a mother and baby’s cardiovascular health include diabetes, sleep apnea, and poor nutrition.
The presence of heart issues and/or these risk factors can lead to cesarean sections, labor problems, preeclampsia, and preterm birth. For those with existing risk factors, before they become pregnant and then once the pregnancy is confirmed, they should work with their OB-GYN and a cardiologist or a primary care provider to lessen the impact of any potential risk factors on the baby. Managing risk factors ahead of time will help once a woman enters menopause.
The Menopause Effect
Menopause, which occurs in most women in their late 40s to early 50s, causes hormonal levels, which previously safeguarded women against heart disease, to plummet. This decline in hormones can contribute to an elevated susceptibility to cardiovascular events including:
- Higher blood pressure, often manifested through hot flashes and night sweats;
- Stiffening of arteries which are crucial for optimal circulation;
- An increase in bad cholesterol and decrease in good cholesterol.
For women with existing cardiovascular health risks, the onset of menopause can accelerate these challenges. Engaging in open discussions with a health care provider about menopause-related changes can help address ways to mitigate any heightened risks of heart disease.
Research Trends in Women’s Heart Health
Women have traditionally been underrepresented in clinical trials, and they are often not designed to understand heart disease in women well. Fortunately, that is changing. After many years of heart health focus on men, there is now a push to recognize cardiovascular risks in women.
There are different types of chest pain that tend to occur more in women and now there’s a new impetus to understand these symptoms and use updated testing methods.
Spontaneous coronary artery dissection is also garnering a lot of attention. This is a heart attack that is more common in women when a tear inside the lining of the heart artery occurs. The SCAD alliance, a group created to focus on this under-diagnosed disorder, is conducting global research. Its goals include improving diagnoses and results and fast-tracking scientific discovery.
Staying Heart Health
Whether a woman is of childbearing age, entering menopause, or anywhere in between, she should talk to her health care provider about managing any potential heart health risk factors. All women should consider starting an exercise routine if they don’t already have one to strengthen their heart muscle, improve blood flow, and raise oxygen levels in the blood.
- Learn more about the American Heart Association’s recommendations for physical activity for adults and kids.
- Learn more about Inova Women’s Comprehensive Health Program
Feature image, stock.adobe.com
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