Myth busting: women and heart disease

Ischaemic heart disease – a condition where the heart muscle doesn't receive enough oxygen-rich blood due to narrowed or blocked coronary arteries – is the second most common cause of death in Australia, just after dementia.

Although the rates of cardiovascular disease have decreased greatly over time, it remains the cause of about a quarter of deaths.

For males and females, the key “traditional” heart disease risk factors are high cholesterol, high blood pressure, poor diet, and physical inactivity. 

However, the Heart Foundation has found that women are often underdiagnosed and undertreated for heart conditions.

They are less likely to receive timely life-saving procedures such as angiograms, which can lead to a higher chance of in-hospital complications and poorer outcomes compared to men.

Women have unique risk factors and may experience different symptoms of a heart attack than men, such as breathlessness or tightness instead of classic chest pain.

Risk factors unique to women

Some examples of these are:

• Premature menopause – oestrogen is cardioprotective, which means it helps to protect your heart and blood vessels. As levels of estrogen decrease during menopause, so does the protection it gives.

• Early or late menarche (onset of menstruation) – how this happens isn’t known, but both have been linked to increased risk of cardiovascular diseases.

• Pregnancy conditions, pre-eclampsia and gestational diabetes – these conditions cause damage to blood vessels that persists even after the baby is born.

• Endometriosis – chronic inflammation from endometriosis may make the walls of blood vessels stiffer.

• Polycystic ovary syndrome (PCOS) – decreased insulin sensitivity and increased triglycerides and LDL-C (“bad” cholesterol) during PCOS can impair blood vessels and make plaques more likely to build up in them.

Additionally, some of the risk factors experienced by both men and women increase the risk of cardiovascular disease disproportionately more in women. For example, the increased cardiovascular risk from smoking is 25% higher and diabetes is nearly 50% higher in women than in men.

There are also heart conditions that affect women more commonly than men, such as spontaneous coronary artery dissection. This most commonly affects women in their 40s and 50s and has symptoms similar to a heart attack. It is a medical emergency that happens when a tear forms in one of the arteries supplying the heart with blood and oxygen.

Heart attacks happen to both men and women, and when they do, the most common symptom for both sexes is chest pain. But women can also experience other, less well-known signs of a heart attack.

These include shortness of breath or difficulty breathing; jaw, shoulder, and back pain; nausea or vomiting; fatigue or tiredness; and dizziness.

If you are experiencing unusual symptoms and think you might be having a heart attack, don’t delay seeking help, call triple zero (000) right away.