Marilyn Lawrence-Wright | It doesn’t just affect men – tackling heart disease in women | Remark

Cardiovascular disease (CVD), an umbrella term for diseases of the heart and blood vessels, including heart attack, stroke and heart failure, is the leading cause of death worldwide and accounts for 30% of deaths in the Jamaicans.

Caribbean countries have high rates of cardiovascular risk factors such as high blood pressure, diabetes mellitus, high cholesterol and obesity, which lead to increased prevalence rates of these life-threatening cardiovascular diseases. Risk factors for heart disease are becoming more prevalent not only in adults but also in adolescents and children. In 2017, 30,000 Jamaican children, between the ages of 10 and 19, were diagnosed with hypertension.

Cardiovascular disease and COVID-19 are often referred to as the twin pandemic. Early in the COVID-19 pandemic, it was clear that patients with COVID-19 and cardiovascular risk factors or established cardiovascular disease had poorer clinical outcomes. More recently, the long-term extrapulmonary impact of COVID-19 has become increasingly evident with increased rates of diabetes mellitus and new-onset heart failure seen in people with COVID-19 disease. Early diagnosis and aggressive management of cardiovascular risk factors and disease are essential if we are to reverse our current explosion of cardiovascular morbidity and mortality.

WOMEN… LISTEN TO YOURSELF!

Heart disease can affect any of us. If you are a woman or if you take care of it, be careful, heart disease is not just a male disease. Heart disease is the leading cause of death for women worldwide, killing more than seven million women each year. Heart disease and stroke cause one in three deaths among women worldwide every year, or about one woman every minute.

The Jamaica Health and Lifestyle Survey III documented higher prevalence rates of CVD risk factors in Jamaican women than in Jamaican men. With one in three Jamaicans over the age of 15 diagnosed with hypertension, the prevalence of high blood pressure among Jamaican women aged 15 or older was found to be 35.8%, compared to a rate of prevalence of 31.7% among Jamaican men 15 years and older. older. One in two Jamaicans (54%) aged 15 or older had a high body mass index, with two-thirds of Jamaican women being overweight or obese.

Data from the American Heart Association shows that women with diabetes mellitus are 50% more likely to have a heart attack than men with diabetes mellitus. Additionally, depression in women is associated with an increased risk of developing heart disease. This association is not seen in men.

In addition to traditional cardiovascular risk factors, certain diseases that only affect women, such as endometriosis, polycystic ovary syndrome, pregnancy-associated diabetes mellitus, and high blood pressure, are associated with increased risk. coronary artery disease (CAD), the leading cause of heart attack. Endometriosis has been shown to increase the risk of developing coronary artery disease by 400% in women under 40.

The warning signs of heart disease in women are often different from those in men. This makes it more difficult to diagnose heart disease in women. Harvard researchers have shown that many women do not experience the crushing chest pain that is a classic symptom of a heart attack in men. Women are more likely to report feelings of indigestion or gassy chest pains. Some women may feel extremely tired or short of breath, or have nausea or dizziness; other women may have no symptoms. Treadmill testing, a test used to help diagnose coronary artery disease, was found to be less accurate in women, with a higher rate of false positive and false negative results. Women also have smaller coronary arteries than men and are more likely to have coronary spasms. This can make angiography, a procedure that uses x-rays and contrast dye to examine blood vessels in the heart, more difficult. These factors often delay diagnosis and timely management of women with heart disease and may contribute to poorer cardiovascular outcomes in women. Women are also less likely to receive recommended treatment for certain heart conditions, and corrective procedures such as coronary angioplasty and coronary bypass surgery are sometimes more difficult to perform.

Research that has linked heart disease in women to dementia is also alarming. According to the study “Cardiovascular Disease and Cognitive Decline in Postmenopausal Women”, by Haring et alpublished in the Journal of the American Heart Association in December 2013, older women with a history of heart disease and heart problems are more likely to develop thinking and memory problems than those without heart disease. Women who survived a heart attack were twice as likely to experience a decline in memory and cognitive abilities as other postmenopausal women without a history of heart disease.

PROTECT AND MINIMIZE RISKS

Knowledge is power. Get informed and protect yourself. There are many misconceptions about heart disease in women, and they could put our women at risk. According to the Lancet Commission, cardiovascular disease in women remains understudied, underrecognized, underdiagnosed and undertreated. The more a woman knows about heart disease, the better her chances of overcoming it. It’s never too late to know your risk of heart disease and what you can do to reduce your chances of developing it. You can help protect your heart by adopting heart-healthy habits:

• Know your numbers and discuss with your doctor what your target numbers should be. You can significantly reduce your risk of heart disease by monitoring your health and maintaining a normal body weight and acceptable levels of cholesterol, blood sugar and blood pressure.

• Do not smoke, actively or passively. Your risk of having a heart attack doubles if you smoke only one to four cigarettes a day. Even if you don’t smoke, regular exposure to someone else’s (second-hand) smoke can increase your risk of heart disease.

• Manage stress levels and treat depression by finding healthy ways to deal with stressors. Maintain a good support network and don’t be afraid to seek professional help if you need it.

• Eat healthy. There are several essential ingredients for a heart-healthy diet – whole grains, a variety of fruits and vegetables, nuts, polyunsaturated and monounsaturated fats, fatty fish (like salmon) high in omega-3 fatty acids, and limited intake of trans fats. , salt and sugar. Read your food labels.

• Be more active. Do at least 30 minutes a day of moderate-intensity exercise, such as brisk walking. Make activity part of your life. Take the stairs instead of the elevator, do yard work or gardening, park further away from your destination, and walk.

Identifying those most at risk of heart disease and ensuring they receive prompt and appropriate treatment can prevent premature deaths. Every woman should take the time to adopt healthy lifestyle habits, including healthy eating, physical activity, and scheduling routine health exams, which can catch potential problems early and can even save your life. Don’t forget to check your heart, be COVID and smart!

– Dr. Marilyn Lawrence-Wright is Consultant Cardiologist at the Heart Foundation of Jamaica and Chief of Cardiology at University Hospital of the West Indies/The University of the West Indies. Send your comments to [email protected]

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