Don’t seek equality in heart health!

International women’s day which falls on 8th March every year, has been designated as a day of equality for women. It started in 19th century in the socialist world and continued as a day of protests in some countries but in others a day of celebrating the womanhood. The United Nations started celebrating it since 1977.

The theme of the year 2021 is women in leadership: Achieving an equal future in a COVID-19 world. Last year saw the remarkable contribution of women as health care workers to combat the COVID Pandemic in the entire country. Nurses constitute more than 90% of the work force. We are proud of their contributions.

   

It is a general belief that heart disease, especially heart attack is a disease of men and for this reason women should not try equity with them. Does this belief hold true in the current era?

Cardiovascular disease is the commonest cause of death in both men and women in the entire subcontinent. More women will have a second heart attack within 6 years of their first heart attack. Diabetes which is common and an increasing problem in our society makes women 3 to 4 times more prone to heart disease and doubles the rate of a heart attack. It, also needs to be remembered that certain diseases only affect women. Endometriosis, polycystic ovaries, diabetes, and high blood pressure of pregnancy, increases the risk of heart attacks . Endometriosis a disorder in which tissues which normally line the uterus grows outside the uterus, like ovaries, fallopian tubes, or intestines. It increases the risk of heart attacks several folds under the age of 40 years.

Female reproductive hormones do offer some protection from heart disease until menopause, when the levels of oestrogen levels drop. For this reason, the average age for a heart attack is 5 years later than men of the same age.  Because of this women underestimate their risk of developing heart related issues, even though at least half of the deaths in women occur due to heart disease and related problems. This protection is lost in females with co existent risk factors like high blood pressure, diabetes, high cholesterol levels, tobacco users and those with family history of premature heart attacks.

Presentation of heart attack in women can be different:

Women often do not experience the classical chest discomfort during heart attack. They are more likely to have warning symptoms and signs like back ache, abdominal pain, jaw pain, shortness of breath, nausea and vomiting. It is for these reasons that there is a delay in recognizing it which leads to more complications and a higher mortality. This is further complicated by reduced reliability of electrocardiogram (ECG) in diagnosing it.  In addition, women require a longer hospital stay and have higher in hospital mortality. The results of stenting are also inferior to their men counterparts. This is partly due to associated risk factors like diabetes, smaller arteries, and late presentation for treatment.

Measures to prevent heart attacks in women

The key is regular exercise, healthy diet with several servings of fruits and vegetables, maintaining ideal weight and no use of tobacco. In addition, periodic medical checks for early detection of high blood pressure, diabetes and high cholesterol levels.

Psycho-social stress is a very important additional independent risk factor. Women in particular are subjected to it much more than men. It is common both for working women and housewives. Men need to understand this and be empathetic and treat them as equals, share their responsibilities and burdens.

Women’s health is very important especially in our society where gender discrimination is rampant. Social evils such as female foeticide and negligible presentation in decision making bodies even for educated females across all the professions is glaring. These factors lead to build up of psycho-social stress and eventually impacting the health of women. Heart related issues are an important component of this.

Gauri Heart Foundation as a mission has been working on preventive measures by optimising the medical treatment of hypertension, diabetes, and related heart diseases. Fifty percent of the patents seen in our camps in 5 districts of J and K were women. Preventive measures are emphasized by the teams and a follow up is being done. The motto of our mission is “No More Heart Attacks”.

Healthy women and mothers are the gatekeepers to the health of the family and the household. Keeping their hearts healthy is an important contribution towards keeping their families and eventually the nation healthy.

Prof Upendra Kaul is a Cardiologist, recipient of Padma Shri and Dr B C Roy Award. He is founder director Gauri Healthy Heart Project

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