World Heart Day 2022: Are women less prone to heart attacks?

By Richa Barua | First Published Sep 29, 2022, 7:00 AM IST

We spoke to Dr Ravikanth, Senior Cardiologist, Kamineni Hospitals, Hyderabad, on the occasion of World Heart Day about women having heart problems and more

Medical experts and health observers say “yes.” Apart from infectious diseases, heart disease is the second leading cause of death in our country annually. Fifty per cent of Indian men who die of heart attacks are under fifty.

Half of these people's lives end within 40 years. Moreover, if we look at the details of the increase in heart disease cases in the country, the number of men is higher than women.

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In our global study, we discovered that while women used prevention strategies more frequently, men used invasive strategies such as percutaneous coronary intervention and coronary artery bypass surgery more regularly. Women develop cardiovascular disease 7 to 10 years later than men.

Endogenous estrogen exposure during the fertile period of life is thought to delay the onset of atherosclerotic disease in women. Before menopause, the CHD event rate in women is low and is primarily due to smoking.

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Women in early menopause (age 40) have a two-year lower life expectancy than women in normal or late menopause. According to the Women's Ischemia Syndrome Evaluation (WISE) study, young women with endogenous estrogen deficiency have a sevenfold increase in coronary artery risk.

Oestrogens influence several metabolic factors, including lipids, inflammatory markers, and the coagulant system.

Systolic blood pressure rises more sharply in older women than in men, which may be related to the decline in estrogen levels during menopause. 14-16 The renin-angiotensin system is upregulated after menopause, increasing plasma renin activity. Postmenopausal women have higher salt sensitivity and sympathetic activity than premenopausal women.

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Women have a lower relative risk of hypercholesterolemia than men at a younger age. Cardiovascular disease is women's leading cause of death and is still largely undiagnosed and untreated.

To improve therapeutic strategies and outcomes in women, health care professionals must be more aware of the differences in the presentation of angina pectoris and ACS between men and women and gender-based interpretation of diagnostic tests. When appropriate, cardiology guidelines should be more focused on gender differences.

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