Heart attacks in Pakistani women under 50 have tripled in the last 15 years, and recent studies have showed that the majority of both men and women report chest pain, pressure, tightness or discomfort as their main heart attack symptoms.
This was stated by Prof Faisal Ahmed, consultant cardiologist and head of the Cardiology Department, Liaquat National Hospital and Tabba Heart Institute, at a seminar titled “Women & Heart Diseases’, organised recently by the Neurospinal & Cancer Care Postgraduate Institute, Karachi.
Yet, Prof Ahmed said, women were more likely than men to report other associated symptoms of heart attack, such as indigestion, loss of appetite, shortness of breath, nocturnal cough, wheezing or pain in the jaw, neck, or arms.
“The chest pains that spread to the left arm and jaw, which are typical in men, are absent in women in around 40 per cent of cases, and when chest pains do occur in women, they’re more likely to be felt in the side and they aren’t necessarily linked to exertion,” he added.
“Although heart palpitations are benign most of the time, they’re definitely worth keeping an eye on. These feelings of missed heartbeats or fast thumping (tachycardia) can be a telltale sign of heart disease. They are never normal when experienced with exertion; you should also see a doctor if your heartbeat is irregular and note the context in which it occurs (mealtimes, strong emotions, physical exertion, etc.), episodes of fainting or faintness associated with dizzy spells, vomiting, nausea, or loss of consciousness can be linked to heart-attack risks.
“‘Regular’ fainting —called vasovagal syncope — caused by low blood sugar levels or strong emotions, for example, can usually be felt approaching with symptoms such as sweating and nausea.”
Prof Ahmed further explained: “Women are also more likely to perceive their symptoms as stress or anxiety, and are more likely than men to report that their healthcare providers do not think that their symptoms are heart-related.
“Cardiovascular diseases affect Pakistani women at least a decade earlier than their western counterparts, in their most productive years; this worrying trend is attributed to multiple factors, including stressful lifestyles, poor dietary habits, smoking (including second-hand smoke, Sheesha & E-Cigarette) or drug misuse and lack of adequate physical activity.”
Guest speaker Prof Abdul Rasheed Khan, consultant cardiologist and ex-head of the Cardiology Department, Abbasi Shaheed Hospital and Karachi Medical & Dental College, said: “In our population, up to one-fourth of female patients default from treatment, especially once they feel that symptoms have regressed. This non-adherence can snowball into further complications, increasing risk of hospital admissions. Awareness can facilitate early and effective disease management.”
“There are several factors that increase your chance of developing heart disease. Almost 50 per cent of all Pakistani women have at least one of three major risk factors for the condition: Diabetes, obesity, family history of heart disease, age (risk increases as you get older), unhealthy diet & physical inactivity. Although some risk factors are beyond your control, there are many things you can do to protect your heart health. It's estimated that 80 per cent of heart disease, including heart attacks and strokes, can be prevented through lifestyle changes,” said Prof Khan, who is also the joint secretary of the Pakistan Hypertension League.
“A woman’s risk of heart disease and stroke is higher after menopause. This higher chance is not completely understood. But cholesterol, high blood pressure, and fat around the abdomen—all things that raise the risk for heart disease and stroke—also increase around this time.
“Many women use prescription hormone drugs for birth control or for reducing symptoms of menopause (called hormone replacement therapy). Birth control pills can increase your risk of having a blood clot, either in the heart or in the legs, and they can also raise your blood pressure. So, if you have a history of high blood pressure or clotting problems, other types of contraception might be a better fit for you, but for most young women, it's safe to take birth control medication,” he elaborated.
“Certain diseases that only affect women, such as endometriosis, polycystic ovary disease, diabetes and high blood pressure that develop during pregnancy, increase the risk of coronary artery disease, the leading cause of heart attack. Endometriosis has been found to raise the risk of developing CAD by 400 per cent in women under age 40. Like men, women can be impacted by a family history of heart disease, particularly when a father or brother was diagnosed with CAD before age 55, or a mother or sister was diagnosed before age 65.”
Prof. Khan suggested: “Whether you are a man or a woman, it’s never too late to lower your chance of suffering a heart attack. Here is what you need to do: quit smoking or don’t start. Do regular exercise; at minimum, walk 30 minutes a day. Eat a diet high in fruits, vegetables, whole grains and fish and low in animal products, simple carbohydrates and processed foods. Maintain a normal weight, blood pressure, blood lipid and blood sugar levels.