Cardiovascular disease up among UAE premenopausals
The risk of cardiovascular disease in women, once considered a problem common among those after menopause (45-55), is on the rise in younger patients largely because of their unhealthy lifestyle choices, says a cardiologist at Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health.
According to the Department of Health, cardiovascular disease (CVD) is the leading cause of death in Abu Dhabi among men and women. The main risk factors for heart disease include diabetes, high blood pressure and cholesterol, smoking, being overweight or obese, and family history of heart issues. About 80 percent of women in the US have at least one risk factor for heart disease.
“It was previously believed that premenopausal women are protected from heart disease because of the beneficial effects of estrogen on the arteries and cholesterol. When estrogen is depleted in the post menopausal state, this can lead to endothelial dysfunction that can lead to blockages of the arteries. Indeed, classic heart attacks due to plaque formation and rupture in the arteries of the heart are predominantly seen in postmenopausal women, however our clinic is now seeing an increase in risk factors and heart disease in premenopausal women, which echoes a global trend,” says Dr. Dima Quraini, staff physician at the Heart and Vascular Institute at Cleveland Clinic Abu Dhabi.
“Premenopausal women are at now at a higher risk of developing heart disease because there is a higher incidence of diabetes, high cholesterol, obesity and complicated pregnancies among this group. They are also at risk of suffering from heart attacks due to less frequent pathologies such as tears in the arteries of the heart or spontaneous coronary artery dissection.”
Dr. Quraini says that many women are still unaware of these risk factors and that is why it takes longer to diagnose heart disease in women when compared to men. Women who suffer a heart attack are more likely than men to die of it.
Sixty four percent of women who participated in a heart health survey of 1,000 residents commissioned by Cleveland Clinic Abu Dhabi in 2020 said that they did not suffer from the common risk factors for heart disease. But about 59 per cent of those women also said that they had not discussed their heart health with their doctor in the past year.
“Unfortunately, I see many women who have never had their cardiac risk assessed. They have not had their cholesterol level checked, been asked about their family history of heart disease, or have discussed any adverse outcomes of pregnancies with their physicians. As these risk factors go undetected, they are offered less aggressive treatment options at earlier stages.”
She shares the example of a new mother in her early 30s who was treated for heart failure at the hospital. “We initially thought that her condition was related to her postpartum status, but on further investigation found that she was genetically predisposed to high cholesterol and her levels were extremely high. She had severe blockages in her arteries and had to have a coronary bypass in her 30s. She was completely unaware of her condition.”
Dr. Quraini says another problem that women with families identify is a lack of time to prioritize their health, including regular exercise. She advises women to apply small daily changes to their lifestyle and avoid quick fixes to get fit.
“Women must avoid fad diets as this does more harm than good because they are not sustainable and can restrict key nutrients. This can cause a severe energy deficit, muscle loss and other deficiencies. Yo-yo dieting can lead to poor cardiovascular outcomes.”
Instead, she says, eating less processed foods and adopting a Mediterranean diet, which is high in vegetables, fruits, nuts, grains, fish and unsaturated fats, such as olive oil, along with 150 minutes of moderate to intensive activity a week, can help maintain a healthy heart.
“The most important message that I try to communicate is that women are just as susceptible to heart disease and heart attacks as men. Most heart diseases can be prevented by knowing your risk and addressing them early.”