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When you think of a heart attack, what image comes to your mind? For most, it would be one of a middle-aged man holding his heart and wincing in pain. From movies and advertisements to popular imagination, there is a widespread perception that heart attack is a man’s disease and affects men more. This is far from the truth, says Dr AR Raghuram, Senior Consultant Cardiac Surgeon at Kauvery Hospital in Chennai. In fact, women face certain risk factors which men don’t, making them more vulnerable to heart attacks in some ways.
Globally, heart diseases are known to afflict men at a younger age compared to women, but they are one of the leading causes of deaths in both men and women. Heart diseases are responsible for one in every three deaths in both sexes. Further, there is evidence to show that known symptoms of heart attacks are ignored by women due to the general apathy towards their health. “Another belief, although it is true to some extent, is that women get heart attacks only after menopause. So, younger women think they won’t get a heart attack,” Dr Raghuram says.
Women are exposed to as much stress as men, if not more. Just like men, they also have career pressures and face a lot more demands at home. “Today, we see ladies even in the 30-40 age group, pre-menopausal women, suffering from heart attacks,” Dr Raghuram points out.
Risk-factors in women
Even medical professionals were once under the impression that young women were not prone to heart attack, and it was perhaps because not enough women came in with complaints. But now, we know of specific risk factors in women, say doctors.
So, what are these risk-factors?
“What women need to understand first is that heart diseases do not afflict us overnight. There are several other illnesses and symptoms which women ignore, and those lead to heart diseases,” says. Dr Raghuram.
Throughout their life, women need to watch out for high blood pressure, mental stress, hypertension, diabetes, high cholesterol and body weight.
Women face hormonal upheaval in their body due to several reasons, like menstruation, pregnancy or menopause. “While none of them are directly linked to heart attacks, they can cause other illnesses like hypertension, high BP or high cholesterol, which lay the path to a heart attack,” Dr Raghuram says. “Women tend to put on more weight after pregnancy, and in their later years,” the cardiac surgeon says, “Women also ignore diabetes, which is considered a pre-heart attack.”
Here are a few other specific concerns women must keep in mind.
One, misuse of oral contraceptives. “While mostly they are used only for contraception, they are also now being misused to postpone the menstrual period for the sake of comfort. If there is an upcoming wedding or some other event and women don’t want to have periods, they take hormonal drugs. Some women take these drugs regularly. This is not good for the heart,” Dr. Raghuram warns. Some studies have concluded the same. “These drugs are essentially hormones - estrogen and progesterone. They have the tendency to retain water in the body, increase weight, increase cholesterol and increase blood pressure, and that is a perfect recipe for heart attack,” Dr. Raghuram warns, “So, don’t use hormonal drugs for convenience.”
Two, while pregnancy itself cannot cause any heart diseases, women who have familial tendency for hypertension, high BP or diabetes can develop it during pregnancy. High BP or diabetes during pregnancy can increase a women's long-term risk of developing of heart diseases.
Three, an important risk is thyroid-related problems. “We have seen a lot of women who come with heart attacks, and we find that they are grossly hypothyroid and they are not even aware. Hypothyroidism causes high cholesterol and hypertension, which leads to heart attacks,” says Dr Raghuram.
So, what are the lessons for women here?
Women should not ignore any complaints of the body. Women must have a good workout regimen and take care of their mental health. Post-pregnancy tests are a must, to check if blood pressure, sugar levels and cholesterol levels are normal. If a woman has the tendency to put on weight under normal diet and workout conditions, she should check if she has any thyroid-related problems.
“If you have any discomfort associated with an effort, something which you were normally doing before, don’t ignore it, go to your doctor, get yourself checked up. Go for an ECG, ECHO and Treadmill Test so we can pick it up early. Don’t be under the wrong impression that heart diseases are more in men,” Dr Raghuram says.
This series was produced by TNM Marquee in association with Kauvery Hospital.