What’s different between a man and a menopausal woman? In cardiac terms: just hormones. A woman’s play of hormones is supposed to give her protection against heart disease. But women, hold your glee just there: a multi-centre study in India recently has said the number of women cardiac patients has grown at 11 per cent or more in the past five years.
The VEDNA (Visualising the Extent of Heart Disease in INdiAn women) study conducted in 51 centres in the country by HEAL Foundation, revealed that 70 per cent of doctors reported that the number of women patients had grown rapidly. The survey found that 54 per cent of about 600 cardiologists interviewed observed a 16-20 per cent overall growth rate in cardiovascular diseases among women in the last five years.
K. Jayanthi, Senior Interventional Cardiologist, SRM Institutes for Medical Science, says, “We are seeing a lot more women in their late twenties and early thirties coming in with heart attacks. This is the category that, we generally assume, is protected from heart disease by their oestrogen.” Hormone levels protect the metabolic milieu in the woman – meaning they help regulate blood sugar, and pressure levels, she explains.
It serves the purpose of keeping the good cholesterol at a higher level and bad cholesterol at a lower level, resulting in better heart health.
But therein enters the villain: changing lifestyles. “A diabetic woman at 35 has the same risk that a man of that age has,” explains Asha Mahilmaran, Senior Interventional Cardiologist, Apollo Hospitals. “We are noticing significant hypoestrogenia (low estrogen levels) among these women. This automatically sets their cardiac risk higher.”
But things are not even as simple as this. Women come in with diabetes, hypertension and obesity, the potent heart disease cocktail. “Today, if I see 80 per cent of post menopausal women and women with hormone deficiencies with heart disease/attack, the rest: 20 per cent: is menopausal. The cardiovascular burden in women between 30 and 50 years has grown rapidly.”
High levels of stress among women who try to balance a hectic work life with home and family upset the delicate metabolic balance in women, cardiologists say. “There is a lot of stress in modern lifestyles. Stress plays an important role in heart disease; all the risk factors are aggravated during stress,” Dr. Jayanthi adds. Additionally, hectic lifestyles set the women chasing after junk, fatty food and a life shorn of serious physical activity.
All these, again, heighten risk factors for women. The VEDNA study also ranked diabetes, stress/hypertension, a sedentary life, lipid disorders, metabolic disorders as top cardiovascular risk factors for women. About 65 per cent of the doctors picked up estrogen deficiency among top 10 risk factors. The manifestations of disease in women might be different, Dr. Mahilmaran says. “Women might have different symptoms, or even ignore them. Even doctors tend not to take these symptoms seriously.”
However, she stresses, “Whatever the age or sex of the patient, the treatment must be the same. What is good for the gander is here, good for the goose.”