Women’s Heart Health: Recognizing the Signs and Reducing Risk

Heart Disease is a major health complication prevalent worldwide and is a culprit for many deaths. This includes the United States where according to the US Centers for Disease Control and Prevention, 44% of women are living with heart disease, and in 2021, it was responsible for 1 in every 5 female deaths. As medical research has progressed over time to better understand the nature of heart complications, it has become apparent that heart diseases, their symptoms and the effects they have can differ between sexes. 

This is essential knowledge that healthcare professionals and students like those studying  a family nurse practitioner program should be well-equipped with when practicing patient care. A 2019 nationwide survey revealed that only 22% of primary care doctors and 42% of cardiologists feel extremely well-prepared to assess cardiovascular risks in women, further demonstrating the knowledge gap in this area. 

Heart Disease Manifestation in Women Compared to Men

While chest pains are a common symptom of heart attacks that occur in both women and men, many women encounter different  symptoms too, often described as a sense of tightness and pressure in areas other than the chest. Sweating, shortness of breath, and tense discomfort in the neck, jaw, upper body and abdomen are other symptoms that women also report experiencing more than men. Specific heart conditions, such as coronary microvascular disease and broken heart syndrome are more common in women. 

Coronary MVD

One major heart complication that develops frequently in women is Coronary Microvascular Disease (Coronary MVD). The American Heart Association highlights Coronary MVD as a form of heart disease that affects the walls and linings of smaller coronary artery vessels that branch out from the larger arteries. This occurs when plaque builds up and blocks the blood supply to the main heart muscle hence leading to spasms, decreased blood flow, and abnormalities in the smaller arteries that eventually contribute to Coronary MVD. 

Broken Heart Syndrome

Broken Heart Syndrome (BHS) is another heart-related disorder that women are more prone to than men. BHS often develops due to stressful circumstances, extreme emotional levels, and can be triggered during the aftermath of serious physical events such as illness, sustained injuries, and surgery. People who experience symptoms of BHS tend to believe that they are having a heart attack due to the similarity of symptoms such as sharp chest pains. However, according to the Mayo Clinic, BHS only interrupts the way that the heart pumps blood and contracts briefly, while the rest of the cardiovascular system functions as normal. This doesn’t mean BHS isn’t serious though — in some rare cases, it can result in death.

Physiological Differences

Differences between male and female anatomy can also contribute to the distinct ways that women develop and suffer cardiovascular complications compared to men. 

Artery Size

One factor when considering the difference between male and female anatomy is the differences in the size of arteries. Women in general have smaller and narrower hearts, blood vessels,  and arteries than men. As arteries that branch out from the heart muscle are smaller in women, they can be more prone to blockages. This also points to the different places where cholesterol builds up in women compared to men. Men, for instance, develop plaque blockages in the larger arteries that provide blood supply to the heart, whereas women develop the same plaque build on the heart's smaller blood vessels called the microvasculature.

Hormones

Hormonal differences are another physiological factor that play a role in the way heart disease affects females differently to males. Evidence has suggested that a lack of estrogen over time can be an influential factor in the ways that women develop cardiovascular diseases. Whilst estrogen is commonly known for its role within the female reproductive system, it is also a vital component in women's cardiovascular health. Estrogen in fact, is regarded as a heart-protector in many ways as it helps to balance the body’s blood pressure, sugar levels, cholesterol, and also regulates arteries. A lack of estrogen can lead to a rise in blood pressure and cholesterol levels, causing the decline of lean muscle mass and elasticity of the blood vessels, in turn increasing a woman's risk of cardiovascular diseases. Experts believe this may also explain why women become vulnerable to heart attacks approximately 10-15 years after men. During menopause, estrogen levels start to decline and in turn leave a person’s blood pressure, cholesterol levels and cardiovascular system more vulnerable to heart complications.  

Preventive Strategies to Reduce Risks

Despite the serious implications that arise from heart disease, there are many useful strategies that can help both women and men who are vulnerable to reduce risks of developing heart complications. 

Diet

Diet is an important factor that can help reduce risks of developing heart disease. Being overweight can also result in higher cholesterol levels that may eventually lead to blockages in your arteries. Foods high in sugar, carbohydrates, and cholesterol can contribute to this, hence should be consumed in moderation. Regular balanced consumption of fruit, vegetables, and protein however are encouraged as they can help ensure your cardiovascular system remains healthy. 

Physical Fitness

Exercising is also an essential strategy in maintaining a healthy heart and reducing risk of heart disease. Regular physical fitness helps burn fat and improve cholesterol allowing the smaller arteries to efficiently supply blood to the main heart muscle. Physical exercise helps boost our cardiovascular system by improving the blood flow in and out of the heart keeping it productive. 

Smoking

Smoking is very harmful to our cardiovascular system and should be avoided completely. Nicotine can damage the blood vessels that connect our arteries together and significantly increase the risk of developing cardiovascular diseases. Weakened blood vessels are more prone to dysfunction from plaque build up.

Health Checkups and Regular Screenings

Regular health screenings and checks are also beneficial for ensuring that the health of our cardiovascular system is adequate at all times. Many women who are vulnerable may never even realize the progression of cardiovascular diseases within them until informed by a doctor, or until they experience the first set of unexpected symptoms. Regular Health screenings are hence able to encourage early detection of potential complications, kickstarting early treatment or preventative measures.

While there are differences in the ways females and males experience heart complications, and unfortunately women have not always been prioritized in the same way they should, we have come a long way in understanding women’s health. With the knowledge outlined in this article, women can better prepare themselves to recognize and act upon symptoms.