Heart attacks can be fatal in anyone. However, women as compared to men need a longer hospital stay and are more likely to die after suffering a heart attack. Moreover, evidence suggests women are more likely to suffer a second heart attack within 12 months of the first episode as compared to men.Also Read - Revised Covid-19 Guidelines By Health Ministry Recommends No Masks For Children Below 5 Years, All Details Inside; Watch Video

A heart attack occurs when the blood circulation to the heart is compromised due to plaque deposition in the blood vessels supplying the heart. However, heart attacks differ noticeably in women in terms of risk factors, presentation and prognosis as compared to men due to differences in their physiology and body functioning. Women as compared to men are also less likely to seek immediate medical attention as they are unable to recognise early symptoms and often tend to ignore their health, putting their family’s needs first. Also Read - Can Omicron Infect You Twice With or Without Vaccination? Experts Speak

Clinical presentation

Heart attacks in women may be difficult to recognise as the symptoms are milder and sometimes mimics acid refluxes. Chest pain or discomfort is less prominent in women. Instead, they may experience other symptoms such as breathlessness, abdominal discomfort, dizziness, fainting, pressure in the upper back area and extreme fatigue more frequently as compared to men. Also Read - Heart Diseases Can Cause Brain Dysfunction: Study

This difference in presentation is because of the type of coronary arteries being affected in the two sexes. While men more commonly tend to develop a block in the major coronary artery, in women the smaller blood vessels supplying the heart are more affected.

Risk factors

In general obesity, pre-existing heart conditions, diabetes, hypertension, high cholesterol levels, use of contraceptive pills, alcohol abuse and smoking are key drivers of high heart attacks in women. For example, a study including 450,000 patients showed diabetes in women as compared to men are associated with a 50% higher risk of dying from heart disease.

Elderly women are at a higher risk of heart attack as compared to their male counterparts. In younger women, the hormone oestrogen is thought to play a crucial role in affording protection against heart diseases. Post-menopause, the level of oestrogen production decreases, increasing the risk of heart diseases. As compared to males, pre-menopausal women tend to have a 14% higher prevalence of hypertension and a more adverse lipid profile. Other female-specific risk factors include hysterectomy and pregnancy complications such as gestational diabetes or pre-eclampsia.

Prevention and management

Regular heart health check-ups in high-risk patients coupled with lifestyle modifications are the keys to reducing morbidity and mortality associated with heart attacks in women. Some of the crucial lifestyle changes include maintaining the ideal weight for height through diet and regular 30 minutes of moderate-intensity exercise.

Important dietary considerations should include a high intake of vegetables and fruits, complex carbohydrates and the inclusion of food rich in omega-3-fatty acids such as oily fish or seeds. Intake of saturated fats, trans fat and cholesterol in the form of fried and processed food should be limited. Smoking cessation is encouraged and alcohol should be limited to a few drinks a week. The use of hormonal medications should be taken only under medical supervision to avoid unnecessary harm to heart health. Last but not the least, all prescribed medications for diabetes, hypertension and other pre-existing medical conditions should be taken as recommended by one’s physician.

(Authored by Dr Magesh Balakrishnan, Consultant Interventional Cardiologist, Manipal Hospital Sarjapur Road, Bengaluru)