Everything You Need to Know About Your Heart Health

Heart health is an important element of women’s overall health but it’s worth being as informed as possible because of certain female-only pre-empting factors. “Being female means women experience gender-specific conditions such as diabetes in pregnancy, pre-eclampsia or endometriosis, which put them at an increased risk of developing heart disease,” says GP Dr Alexis Missick at UK Meds. Additionally, being female means having smaller heart and blood vessels than men, so structurally their risk is higher.”

There are currently more than 3.6 million women in the UK living with heart disease, while in the US that figure is closer to 50% of the population. Despite such worrying statistics, women are less likely than men to present with symptoms and be diagnosed. “Heart disease typically presents later in women than men and tends to be more severe,” adds Professor Michelle Bloom from the Department of Medicine at NYU Grossman Long Island School of Medicine. “When a woman has a heart attack, or another cardiac event, she is more likely to die or have a bad outcome. This is poorly understood, but I suspect part of this stems from the fact that women tend to ignore or minimise their symptoms, so there is a delay to seeking medical care. In addition, when seeking medical attention, a woman with cardiac symptoms might not be taken as seriously.”

Although there aren’t any female-specific heart conditions, there are ones that disproportionately affect women. SCAD (which stands for spontaneous coronary artery dissection) is one such one with shocking statistics; 80% of those affected are women and 30% are women who have recently given birth or are in their final trimester. SCAD occurs when one or more of the inner layers of a coronary artery breaks away from the outer layer. Another condition that appears to affect women more than men is pulmonary arterial hypertension (PAH), which arises due to high blood pressure and poor blood flow in the arteries. This causes the heart to have to work harder which can lead to heart failure.

There are many different types of heart disease. Common ones include coronary artery disease (caused by plaque in the walls of the arteries that supply blood to your heart) and arrhythmia (a condition is when your heart beats too slowly, too fast or in an irregular way). While some women may experience no early symptoms of these conditions, others may feel them acutely. Whether or not you’ve been diagnosed with any kind of heart disease, there are some warning signs that you should never ignore and that should always be checked out by a healthcare professional. These include chest pain, shortness of breath, heart palpitations, loss of consciousness and dizziness. While there are no specific symptoms that only affect men, it’s a different story for women, whose may include sweating, nausea and pains in the neck, jaws and abdomen. “Women may sometimes report feeling like their bra is too tight or having a band around the chest. They also can sometimes feel dizzy or lightheaded,  have indigestion, palpitations or just extreme fatigue,” says Professor Bloom. “I can tell you countless stories from my female patients who either ignored their symptoms or thought their symptoms could not possibly be from heart disease and therefore they delayed seeking medical care.” If you do receive a diagnosis, knowing a little of what to expect can be a comfort. “Women can expect regular cholesterol or lipid checks, kidney tests and complete blood counts if diagnosed with a heart condition,” adds Dr Missick.

Biological factors can predispose women to cardiovascular disease. “There are a lot of sex-specific issues that predispose us to cardiovascular disease, including early first period, early menopause, polycystic ovary disease and issues during pregnancy such as high blood pressure, gestational diabetes or preeclampsia,” says Professor Bloom. Menopause, a time of huge change in a woman’s life, is a critical time for heart health and it's particularly important to be aware of any signs or symptoms that may occur at this time. “Menopause means a drop in oestrogen levels and we know oestrogen is generally protective against cardiovascular disease,” explains Professor Bloom. In addition to hormonal changes, increased fat in the abdominal area and rises in cholesterol, blood sugar and blood pressure can all add to the risk.

Although growing older presents plenty of health challenges we can’t always control, there are some risk factors for heart disease we can try to keep on top of. Although it can be a distressing and disruptive time for many, trying to adopt a positive, health-first mindset when the menopause does hit, will help reduce the risk of heart health problems too. “Menopause is an opportune time to recognise and embrace the changes in our bodies, but also to take action to decrease our risks,” adds Professor Bloom. Staying active and having a regular exercise schedule will help hugely, as will maintaining healthy eating habits and keeping an eye on your blood pressure and cholesterol. “It is never too late to take charge of your heart health. Even small changes can make such a big difference to your risk; also really listen to your body because, if something doesn’t feel right, it probably isn’t, and you should not wait to seek medical care,” she says.

Alongside regular exercise and a good diet, experts are increasingly suggesting keeping an eye on your cardio fitness too. Cardio fitness, as measured by a metric called VO2 max, is the maximum amount of oxygen the body can use during exercise and it’s important to maintain decent levels for good heart health. Although it’s normally only measured in professional clinics, owners of Apple Watches are in luck as the devices can now estimate levels of cardio fitness and track any changes using their watch. There’s even a notification warning system if your levels fall too low, which is useful for galvanising you into action. And although it may seem like an impossible task, reducing your stress levels is critical for reducing the risk of cardiovascular disease. “We all live very stressful lives and women tend to carry the weight of the world on our shoulders,” says Professor Bloom. “But stress increases cortisol levels which increases cardiovascular risk. I always encourage my female patients to find something they can do to decompress.”

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