We’re almost three times as likely to die from heart disease as breast cancer, says Dr Mel Wynne-Jones
Heart disease is often seen as a male problem, but in reality we’re not far behind the
men. And although coronary heart/artery disease (CHD) doesn’t usually affect us
until after the menopause, younger women can have heart attacks too.
Pregnancy complications, such as raised blood pressure, early-onset pre-eclampsia (toxaemia), high blood sugar and premature delivery, may be early warning signs for some women, according to recent US research.
And we can’t do much about our family history (for example, heart disease, diabetes, high cholesterol or blood pressure levels), although you should mention these to your GP.
But most heart diseases take years to develop and it’s never too late to make healthy changes that can really help and which will reduce your risk of stroke, kidney damage and other circulatory diseases too.
Living with CHD
Around 875,000 UK women are living with CHD and almost one in 10 of us dies from it. CHD develops as arteries become narrowed by deposits containing blood cells and cholesterol.
These reduce blood and hence oxygen flow to the heart, especially on exertion, producing tight central chest, neck and arm pain (angina) that’s usually relieved by rest.
But if it lasts more than 10 minutes or is linked to breathlessness, sweating, palpitations and/or faintness, this could be a heart attack and trigger a cardiac arrest or permanent heart damage, so call 999.
Angina and heart attacks are treated with medication that makes blood less likely to clot (such as aspirin), lowers blood cholesterol levels (statins), improves the heart’s efficiency or dilates narrowed arteries.
Surgery to replace and/or bypass one or more arteries, or to widen them using a stent (tube), may be needed, especially after a heart attack.
What else can go wrong?
CHD can lead to heart failure (HF) – damaged heart muscles which pump less efficiently so that fluid builds up in the lungs and/or ankles.
Narrowed or leaky heart valves or a fast, irregular heartbeat (such as atrial fibrillation) can also strain the heart or lead to blood clots that can trigger a stroke.
Cardiomyopathy, disease of the heart muscle itself, may be inherited or caused by viruses, alcohol or other toxins. These conditions can all produce chest pain, palpitations, breathlessness, ankle swelling or faintness/dizziness. They are treated with medication, surgery and/or a pacemaker.
Tests you may need
Have your blood pressure checked at least every five years. Your GP may suggest blood cholesterol and/or glucose (sugar) tests and tests for thyroid disease, too.
If you have symptoms, you’ll need a heart tracing (ECG), possibly for 24 hours or longer, to ‘catch’ palpitations.
Scans – echocardiogram (ultrasound), thallium/PET (a tiny injected dose of radioactivity) or CT (detailed X-rays) – can show the shape of your heart valves and muscles, how efficiently they are working, as well as oxygen flow and calcium deposits that may indicate CHD.
Angiography involves injecting a special dye into an artery in your your wrist or groin so that your coronary arteries show up on an X-ray.
5 Personal risk factors you can fix
1 Activity – aims for 30 minutes’ brisk walking (or similar) five times a week. Stand up and walk around for at least five minutes in every hour.
2 Diet – eat more fresh fruit, vegetables, nuts, pulses and less salt, sugar and fats. Avoid trans or hydrogenated fats.
3 Waistline – maintain a healthy weight and lose your tummy if you are ‘apple-shaped’. It will reduce your diabetes risk too.
4 Smoking – this doubles your heart attack risk. Nicotine replacement therapy or medication can help you to stop. Speak to your practice nurse or visit nhs.co.uk.
5 Alcohol – a glass of red wine contains resveratol, which may protect, but drinking more than recommended amounts increases your CHD risk.