- Dr Nupur Gupta, Director - Obs & Gyneocologist, Well Woman Clinic

Coronary artery disease (CAD) is a major cause of cardiovascular death worldwide and India is no exception with the highest rate of CAD patients accounting for over 20% of the global burden.

Although Triple Vessel Coronary Artery Disease (TVCAD) is less common among young patients (<45 years), poor lifestyle habits are contributing to a rise in such patients.

Post-menopausal Women and heart ailments

Each year more women die of cardiovascular disease than from all the cancer combined together. For every woman that dies from breast cancer, there are six that die from heart disease and unfortunately, younger women are more likely to die from CAD than older women.

While increase in body weight and poor lipid profiling are one of the major factors contributing to the risk of cardiovascular risk in women. Several studies have linked the biological and hormonal changes occurring during the transitional phase of menopause. As the decreasing levels of estrogen during this phase is primarily responsible for endothelial dysfunction and enlarged vessel diameters, which are the markers of early and adverse vascular changes.

It is thus proven that the reduced levels of estrogen in post-menopausal women makes her equally vulnerable and exposed to risk of CVD as equally as lipids.

At this rate, India will have the largest heart disease burden by 2020. Most of us believe that CAD is the disease of men, and women only have to worry about breast cancer or gynaecological cancer. Contradicting to this fact, over 50,000 more women die in comparison to men every year across the globe. Apart from lack of awareness about the disease, under-diagnosis and under treatment attribute to the excess mortality among women.

Apart from age and family history, controllable risk factors including increased cigarette smoking, high levels of cholesterol, high systolic blood pressure and diabetes have been noted to raise the risk of atherosclerosis by around 90%. In fact, over 20% of diabetic patients have suffered from this condition.

Asymptomatic complications

Heart disease in women doesn’t have typical presentation like retrosternal chest heaviness in men. One should immediately consult a doctor if they have Difficulty in breathing especially while gong upstairs or walking fast, Unusual fatigue or dullness, Pain abdomen or pain in shoulders, back, arms or hands, sweating or dizziness. Because of atypical presentation, a diagnosis of heart disease is delayed in women leading to worse outcome. In general, one in five women has some form of CVD Cardiovascular and almost one-third of women who have a heart attack die within one year.

Prevention is better

Wide spread awareness, early recognition of symptoms and diagnosis of CAD is of utmost importance to save invaluable lives of caregivers of the society.

Women today are strictly preached to start taking care of their heart health as soon as they reach 40 years of age or maybe earlier. To maintain good heart health, doctors recommend a few additions to the daily routine:

- Exercise 30 to 40 minutes daily preferably brisk walking.

- Intermediate cardiovascular activities like swimming, tennis, aerobics or Zumba is good along with stretching, pilates, and yoga for better muscle toning.

- Maintain body fat at an ideal BMI is essential.

- Checking body fat percent and ensuring that it is in the ideal range is necessary.

­- A well balanced, high fiber, moderate protein is necessary to maintain a good lipid profile.

- Consult a nutritionist and discuss food items that raise HDL levels. Green leafy vegetables, walnuts, dark chocolate, fish or wheat germ may be recommended in your dietary recommendation.