Health Report
heart attacks: are you at risk?
We’re constantly being reminded about our breast health and how to check for lumps or bumps regularly, but most of us don’t realise that we’re far more likely to die from a heart attack than we are from breast cancer. The stats are staggering – some 69,000 women have a heart attack in Britain each year, which is nearly 20,000 more than are diagnosed with breast cancer. and, even more worryingly, recent reports show that women’s risk of having a heart attack is significantly more elevated than men if they lead an unhealthy lifestyle. So what’s the reason for this troubling trend?
on the rise
For decades, doctors and patients have thought of heart disease as a condition that mainly affects overweight, middleaged men. ‘Men tended to drink more alcohol and smoke more than women, while oestrogen is thought to be cardio-protective,’ explains private GP Dr Jeff Foster. But recently, rates have soared and, according to the British Heart Foundation fact sheet, published in November 2018, one in 12 women now die from coronary heart disease each year.
Dr Foster believes this is because when it comes to unhealthy lifestyles, women are catching up with men. While smoking rates may have gone down, alcohol consumption is still high and obesity, caused by poor diets and lack of exercise, is leading to huge problems. Consequently, women are developing high blood pressure and Type 2 diabetes, putting them at serious risk of a heart attack.
elevated risk
We all know that smoking, a poor diet and lack of exercise can increase the chance of a cardiac catastrophe, but a study by Oxford University, involving half a million middle-aged people, has revealed that women are much more likely to suffer from an unhealthy lifestyle than men. Reports show that the heart attack risk in women with Type 2 diabetes surges by 96%, whereas for men the threat only rises by 33%. Similarly, women who have stage 2 hypertension (severe high blood pressure) increase their chance of a coronary by 152%, compared to 71% for men, and for smokers, women’s risk of a heart attack is double that of men (246% versus just 123%).
But why? Scientists writing in the British Medical Journal believe that despite the elevated risks, women are still receiving worse care than men. According to reports, women with diabetes, for example, are 15% less likely than men with the same condition to receive the recommended level of care,
‘We need to eat less, move more’
and may be less likely to achieve the desired outcome when treated for cardiovascular risk factors. Stats also show that women in Britain are 50% more likely than men to have a heart attack initially misdiagnosed.
Bad publicity
But it’s not just the medical experts that are to blame. ‘Heart attacks remain a bigger cause of death in women than breast cancer, but it doesn’t receive the same publicity or attention,’ explains Dr Foster. ‘We’re eating worse and exercising less, which is raising our LDL (bad) cholesterol and pushing up our blood pressure, which is all adding to the risk,’ he adds. But women themselves still see heart disease as a typical male condition. And there’s even the idea that it’s not something women get. How wrong could they be?
Worryingly, it’s not just case numbers that are rising, but death rates too. Part of the problem is that male heart attack indicators, which are well researched and documented, can differ from lesser-known female symptoms. ‘Women do not present in the same way as men,’ explains Dr Foster. ‘They don’t often have typical left-sided chest pain that “classic” heart attack patients get.’
The feeling of an elephant sitting on your chest is more likely to occur in men than women – in fact, studies reveal 43% of women who experience a heart attack, don’t have any chest pain at all. Women should look out for less obvious symptoms, such as extreme fatigue that has lasted days or even weeks, pain in the upper back, shoulders, neck and jaw, profuse sweating, nausea, dizziness and sleeplessness.
These symptoms can often be missed or dismissed as indigestion, a trapped rib or gallstones, so it may take a while for women to seek help. But by the time they reach A&E, they may have suffered significant heart damage. ‘In heart attacks, every second counts,’ warns Dr Foster.
What’s more, aftercare for women may not be up to the same standard as it is for men. A report earlier this year revealed that women are less likely to have tests, such as an ECG (electrocardiogram – a simple test to check your heart’s rhythm and electrical activity), and are also less likely to be offered implantable devices that prevent deaths later on. It’s no wonder that despite 119,000 men being diagnosed annually, women are twice as likely to die in hospital after suffering an attack.
Keep your heart healthy
Experts from the Oxford University team believe that unless British women improve their lifestyle, their rate of heart attacks will swiftly catch up with men. Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, thinks it’s vital that perceptions shift away from heart attacks and heart disease being just a male problem. ‘Heart disease does not discriminate. Regardless of your sex, risk factors such as high blood pressure, smoking and diabetes increase your risk.’
According to Dr Foster, we need to eat less and move more to tackle obesity levels, which can be a trigger for heartharming diabetes and hypertension. Quitting smoking and reducing our alcohol intake is a must, while eating healthy fats found in olive oil, avocados and almonds can also help maintain our levels of good HDL cholesterol, while reducing levels of bad LDL cholesterol.