Heart disease is actually the number one killer of women, causing one in three female deaths.

Cardiovascular diseases (CVD), including heart disease and stroke, take lives prematurely. In fact, they cause 17.3 million deaths every year. By 2030, it is expected that 23 million people will die from CVDs annually.

It is a myth that heart disease and stroke only affect older, male, rich populations. CVDs affect as many women as men; however, their risk is seriously underestimated. In fact, heart disease is actually the number one killer of women, causing one in three female deaths — shockingly, that’s about one death a minute!

Children are vulnerable too as the risk for CVDs can begin even during the foetal development, and increase further during childhood with exposure to unhealthy diets, smoking and due to lack of exercise. Children might suffer a double burden from heart disease and stroke.

The most common type of heart disease is coronary artery disease, which is the narrowing or blockage of the coronary arteries. Some people are born with abnormalities (congenital heart disease). Heart disease includes coronary artery disease (the most common form of heart disease), arrhythmias (abnormal heart rhythms), heart failure, heart valve diseases, and congenital heart disease (CHD).

CVDs include dysfunctional conditions of the heart, arteries, and veins that supply oxygen to vital life-sustaining areas like the brain, the heart itself and other vital organs. If oxygen doesn’t arrive, the tissue or organ will die.

Ischemic heart disease is the technical term for obstruction of blood flow to the heart. In general, this results because excess fat or plaque deposits are narrowing the veins that supply oxygenated blood to the heart. Excess build-up of fat and plaque are termed arteriosclerosis and atherosclerosis. Equally significant would be the inadequate oxygen flow to the brain, which causes a stroke.

Damage to the heart tissues from CVDs or from heart surgery will disrupt the natural electrical impulses of the heart and result in cardiac arrhythmia (an abnormally high or abnormally low heart rate). This could interfere with blood flow and even initiate a heart attack. Proper ranges of cholesterol are also important in the prevention of heart attack or stroke. Cholesterol is not actually a damage mechanism but is more an indicator of compromised liver function, and increased risk of heart attack. CVDs, principally heart disease and stroke, are the nation’s leading killer for both men and women among all racial and ethnic groups.

The most common heart attack symptom in women is some type of pain, pressure or discomfort in the chest. But it’s not always severe or even the most prominent symptom. Women are more likely than men to have heart attack symptoms unrelated to chest pain such as neck, shoulder, upper back or abdominal discomfort, shortness of breath, nausea or vomiting, sweating, lightheadedness or dizziness and unusual fatigue.

Although the traditional and primary risk factors for atherosclerotic heart disease are smoking, sedentary lifestyle, hypertension, diabetes, high cholesterol, high blood pressure and obesity hypercholesterolaemia and a genetic predisposition of the disease to affect women or men, other factors may play a bigger role in the development of heart disease in women. For example: metabolic syndrome — a combination of fat around the abdomen, high blood pressure, high blood sugar and high triglycerides. Mental stress and depression affect women’s hearts more than men’s. Smoking is a greater risk factor for heart disease in women than in men. In some women, plaques build up as an evenly spread layer along the artery walls, which cannot be treated using procedures such as angioplasty and stenting, which are designed to flatten the bulky, irregular plaques in some men’s arteries. Aspirin therapy benefits both men and women. In women, aspirin therapy seems to reduce the risk of stroke more than in men, while in men it reduces the risk of heart attack more than it reduces stroke.

Regular screening is also an important way to prevent heart trouble. The earlier one starts screening and treating it, the more the disease can be prevented.

World Heart Day, an initiative run by the World Heart Federation (WHF), is aimed at increasing public awareness of heart disease and, by informing the public and influencing governments, at developing appropriate policies.

The main prevention tips are: Follow a heart-healthy diet, improve cholesterol levels, exercise, control diabetes, control high blood pressure, control weight, manage stress and quit smoking. The bottom line for prevention is to follow a heart-healthy lifestyle.

(The writer is Medical Director & CEO, Kalra Hospital, Sri Ram Cardio Thoracic Neurosciences Centre, New Delhi. Email: dr_rnk@hotmail.com)

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