Women and Coronary Artery Disease

Coronary artery disease (CAD) ranks number one among heart diseases in causing much morbidity and young deaths.   In this, there is a block in the coronary arteries (vessels supplying blood to the heart), thus curtailing the blood supply.    CAD affects both men and women.  Women have some unique risk factors for developing CAD and   the manifestations may not be typical, thus delaying the diagnosis and   treatment. 

Before menopause, women are protected from coronary artery disease due to the feminizing hormone estrogen. But after menopause, when the levels of estrogen reduce, they become more vulnerable to heart attacks. Women who take contraceptive pills are more prone to develop   a high lipid level which is a risk factor for CAD.

Clot   formation in the blood vessels during pregnancy and or delivery, increases the risk for developing CAD.  Piece of this clot can dislodge and enter a coronary vessel via circulation, and block it.

Women are emotionally more sensitive and susceptible to mental stress.  This makes them more vulnerable to heart problems. During   menopause many women suffer from depression. Due to this, they do not follow the dietary restrictions necessary for avoiding/treating CAD and are not compliant with drugs.

Women tend to have more central obesity.  Thus they tend to suffer more from the   harmful effects of central obesity, i.e. diabetes, hypertension and cardiac problems.  Women who use   tobacco and or   alcohol are more vulnerable to CAD as compared to men, because their   body is not capable of handling   these toxic products.

Features of CAD in women are different. They usually do not   have the typical chest pain as men. The pain tends to be more in the neck, upper back or any other uncommon site. Sometimes, they may feel only nausea, giddiness, breathlessness or fatigue. Because of these atypical features, diagnosis of CAD is often delayed in women.  The exertional breathlessness is more as compared to men.

Statistics show that more elderly women suffer from CAD than men. Considering the risk factors making women more vulnerable to CAD it is prudent to prevent it.

Eating a correct diet is very important preventive measure. Food should contain plenty of green vegetables, fresh fruits, whole grains and cereals. Regarding meat products, except fish all others should be avoided as meat products can increase cholesterol and obesity.

Regular physical   exercise is useful to avoid obesity. Therefore it is important      to do exercise preferably daily or at least 3 times per week for at least 30 minutes. Girls should be   encouraged to be physically active since childhood.  Contraceptive pills is a good option for spacing between births of  2 children but  once a woman has no desire for more children, it is better to go for permanent sterilization   instead of taking pills. 

Alcohol and smoking     should be   avoided.  Adequate physical rest is also important. Mental stress should be avoided by relaxation techniques like creative activities, yoga and meditation. If hypertension and diabetes are present, they should be well controlled with regular medication. 

In case a lady has any symptoms suggestive of CAD, she should not hesitate to seek medical advice.  After the diagnosis is confirmed, she should be compliant with medicines and life style measures.

Dr. Rachna Pande

Specialist internal medicine

Ruhengeri Hospital

Email: rachna212002@yahoo.co.uk