Healthy living
Body matters
Women and heart disease
Women over 50 – even slim, healthy eaters – are more likely to suffer a heart attack than get breast cancer. Melody Stewart finds out why
Lynn Connor had no idea she was having a heart attack when chest pains began one sunny spring day in 2004, so she didn't call 999. Instead, her husband took her to their GP, who called an ambulance immediately. On the way to the hospital she was given clot-busting drugs and later had angioplasty and five stents inserted to prop open a single blocked artery.
"I wasn't overweight," says 56-year-old Lynn, "In fact my nickname was 'tin ribs', but although I ate healthily, I'd averaged 20 cigarettes a day for 20 years. I'd also been treated for high blood pressure, but I'd stopped the medication two years before the heart attack when the readings normalised." She also had a high blood cholesterol reading of six mmol/l (millimoles per litre of blood).
A possible contributory factor in Lynn's case was the level of pressure she had endured in previous months. "We had been to hell and back," she said. "My daughter-in-law had premature twins at 25 weeks, so I was driving a 100-mile round trip to the hospital every day for four months."
Coronary heart disease (CHD) kills over four times more women than breast cancer does. Heart and circulatory disease is the number one killer of women, yet the myth persists that it is only overweight, middle-aged businessmen, stuffed full of corporate lunches and stress, who suffer from CHD.
Although women are less at risk in earlier life, after the menopause the risks are equal. That is why the American Heart Association, the European Society of Cardiology (ESC) and the British Heart Foundation (BHF) have campaigned to raise awareness of the real risk of coronary heart disease among women.
Professor Silvia Priori, chairperson of the ESC Women at Heart campaign in 2005, said, "Women think 'I can smoke or over-eat' as they have not seen their female peers having heart problems up to the age of 50. That's because in women it strikes later, but it does strike. And then it is often after years of unhealthy living, often with insufficient exercise and an inappropriate diet. So women need to be better educated on the importance of heart-healthy lifestyles and sufficiently screened for risk factors before heart disease strikes."
While the female hormone oestrogen seems to protect women before the menopause, a 2003 study by Nottingham University found no evidence that the synthetic oestrogen in Hormone Replacement Therapy (HRT) reduced the risk of heart disease. In fact some research shows it slightly increases the risk of heart attack, stroke and dangerous blood clots. So how do women reduce these risks?
Eat heart-healthy foods
The BHF advises cutting down on fatty foods such as burgers, sausages and pies, avoiding salt, drinking alcohol in moderation and making sure you eat at least five portions of fruit and vegetables a day. They also recommend including oily fish such as mackerel and salmon in your diet at least once a week, as there is consistent research evidence that omega-3 fatty acids in such fish can help protect against heart and circulatory disease.
Take exercise
To keep your heart and circulation in good shape, be active on at least five days a week for 30 minutes, broken up into 15-minute periods if you prefer. You need to exert yourself enough to feel warm and slightly breathless but still be capable of holding a conversation. However, if you are not accustomed to exercising regularly, consult your GP before you begin and don't try to do too much too quickly.
Quit smoking
Women smokers have a higher risk of death from heart disease than male smokers, according to an Italian study published in 1999; it also warned that the difference is greater for heavy and long-term smokers. Whatever your sex, smoke-damaged arteries attract fatty deposits that restrict the blood flow to the heart muscle. Smoking also has the effect of making blood more sticky and likely to clot - this could lead to a blockage in an artery, which can cause a heart attack.
Reduce stress
Little is understood about how various kinds of stress affect the body at different ages. The symptoms include constant tiredness, tearfulness, palpitations, sleep problems or nausea. If obvious remedies - managing your time more efficiently, taking more exercise, learning stress-reduction techniques - don't work you might need professional help. You can find a therapist at the British Association for Counselling and Psychotherapy website www.bacp.co.uk or call 0870 443 5252.
Vital checks
If you know you have some of the risk factors outlined above, you should ask your GP to do a few basic checks such as blood pressure, weight and tests for cholesterol and triglyceride levels. Most of all, you need to be aware that although coronary heart disease is still the UK’s single biggest killer, it is largely preventable.
Reader comments
Re high cholesterol: in a book I found in a library whilst in New Zealand two weeks ago, written by biologist Dr Sharon Moalem, she states that cholesterol is higher during winter than summer. According to her, the sun and Vitamin D play a role.
Posted by: Mrs Elvira Madelin | 06/04/2008 18:57:49
I am a woman aged 56, non-smokers, always exercised at a gym 3 times a week for last 20 years, eat incredibly healthily. I started suffering from angina last September, my doctor referred me to the local hospital for tests. I have had cholesterol tests, ECG, Echocardiogram, thallium scales, chest x-rays. I am currently taking beta-blockers, aspirin and a GTN spray for emergencies. Six months on I am still in the dark, I don't know the results of my tests, because everyone is blaming everyone else for losing the results. Meanwhile I am just left waiting, wondering what to do next, in a state of anxiety. Nobody seems to care. Meanwhile, my husband has had a heart attach completely out of the blue - but at least he's had proper treatment. What is the point of having all these expensive tests if the results only get lost - or not conveyed to the patient. I'e never been told what my cholesterol is like even though I have had umpteen fasting tests. I'm totally disillusioned with the NHG.
Posted by: Geraldine Allen | 02/04/2008 12:10:14
Regarding high cholesterol, my surgery has started doing patient MOTs. Last May my cholesterol reading was 6.1; the nurse was concerned & tries to aim for 4.5. I changed what I could diet-wise, not much in fact, but now buy the expensive margarine & drink de-caff. tea & coffee. I already exercise adequately. My check-up reading in December was 6.6! Is this really a losing battle? The Dr. is not worried as things fluctuate so. What is the solution?
Posted by: Janet Eden | 01/04/2008 20:26:29
Information on this site is for interest only and is not a substitute for professional medical advice. You should consult your own doctor about any specific health concerns.