Heart Disease

Almost twice as many women in the UK die from a heart attack or circulatory disease as they do from cancer. 5 times as many die from Coronary Heart Disease (CHD) as they do from breast cancer. CHD kills 1 in 5 women (approx. 70,000 in 1995). Women tend to assume that CHD is a man’s disease and that it is men who are the victims of the disease but that’s not the case. Older women as opposed to young women are most at risk of a heart attack and sudden death. Sadly fewer women than men survive a heart attack but if they do the attack may well result in years of disability and the quality of their lives will be seriously affected.

It is essential that we all know and heed the warning signs if we are to prevent a heart attack. We shouldn’t ignore central chest pains, which may simply be indigestion, but could be something far more serious. We need to take action and see the GP if there is a tight feeling in the chest or breathlessness when we try to hurry, or when we are carrying heavy shopping. Neither should we ignore any twinges we might feel going down the arm and up into our necks since they could indicate that something is seriously wrong. Women who suffer from depression appear to be more susceptible to heart disease, but their symptoms of erratic heart beat and panic disorders can often be wrongly diagnosed as distressing emotional problems surrounding the depression, instead of the warning signs of possible coronary heart disease.

We would be foolish to not take notice of these symptoms and if we have chest pains we should go to our GP and ask him to investigate them. However, if the pain is crushing an ambulance should be called immediately because it could be a heart attack, and fast medical attention is vital. What can we do to prevent CHD, a heart attack or worse still, an early sudden death? 17% of premature deaths in women are from coronary heart disease. It does mean changes in lifestyle, but no woman wants to cause her family and loved ones the distress of an early death. Neither would she want to impose on them the responsibility of looking after her if she was to survive the attack and became disabled, and especially so if she lived on her own.

The heart is a muscle which pumps oxygen rich blood around our bodies through a system of veins and arteries. The heart requires oxygen and nutrients itself to function efficiently. CHD can affect and interfere with the flow of blood through the coronary arteries and cause the heart to pump less effectively. Coronary heart disease affects the arteries in two ways. In the first place the artery walls can get “furred up” restricting the space inside the artery and making it more difficult for the blood to flow through. When this occurs it is known as atheroma and it affect some people more than others. Secondly, if a blood clot forms in the arteries, which supply the heart muscles with oxygen and blood, it can cause a blockage of the artery and this condition is called thrombosis. Atheroma or thrombosis can cause angina (pains in the chest, neck and arms), or a heart attack, or even sudden death. Angina is the most common form of coronary heart disease and takes the form of a pain in the chest brought about by exercise or emotion. Heart and circulatory diseases are the UK’s biggest killers and the death rates from CHD in the UK are amongst the highest in the world. These are figures not to be proud of, so we should all be aware of the risk factors surrounding coronary heart disease.

26% of British women still smoke despite the warnings of risks to their health. 11% of deaths from coronary heart disease in women are due to smoking. Women who smoke but also take the contraceptive pill increase their risk of coronary heart disease. If a woman has high blood pressure, and especially when the blood pressure is continually raised, there can be a major risk of CHD or stroke. A major risk factor is diabetes, and women with it are three times more at risk, than those who are not diabetic. If they smoke or have high blood pressure the risk increases still further. A further risk factor is high blood pressure, which can be genetically inherited, or it can develop if a person is overweight, eating large amounts of salt or drinking excessive amounts of alcohol. Getting stressed out, or taking certain drugs, or having kidney disease or narrow arteries are further risk factors.

Women whose father or mother died of a heart attack before the age of 60 are at risk and 5 times more likely to have fatal heart attack themselves. Being overweight is linked to higher blood cholesterol, raised blood pressure and diabetes and it could cause a person to become a heart attack victim. One in three women have high blood pressure but are not receiving treatment. A person with high blood pressure is twice at risk of a stroke, so it’s wise to have your blood pressure checked regularly.

Until the time of the menopause women do not have the same risk of coronary heart disease as men, because of the female hormone oestrogen which keeps blood vessels healthy and prevents diabetes. After the menopause research indicates that women taking hormone replacement therapy(HRT) halve the risk of death or disability from CHD and as a bonus the HRT helps to protect their bones and the risk of the thinning bones disease, osteoporosis. We need cholesterol in our bodies to make healthy cells and hormones and the cholesterol is carried around our bodies in the bloodstream. But if we have too much cholesterol it starts to furr up our arteries. We can lower our cholesterol levels by watching our fat intake in our diet. The average diet in the UK is most unhealthy and we eat too much fat and not enough fruit and vegetables We need to eat polyunsaturated and monounsaturated fats (vegetable oils such as sunflower, rape seed and olive oil etc) instead of saturated fat (animal fats such as milk, butter, cheese, fatty meat, chicken skin etc.

To help yourself avoid coronary heart disease ensure you have an adequate intake of vitamins from your diet or consider vitamin supplements. Recent research suggests vitamins A C and E ( termed the ACE vitamins) in particular may afford some protection from heart disease. Low dosages of aspirin are known to reduce the risk of CHD but aspirin should only be taken on a regular basis on the advice of your GP. Drinking 1 or 2 units of alcohol a day is also associated with lowering the risk of death from heart disease amongst women, but more than two units a day raises blood pressure and can trigger abnormal heart rhythms and heavy drinking can cause actual heart failure. Exercise is a major factor in lowering blood pressure and the risk of coronary heart disease so aim to do 30 minutes of physical activity every day. Stress can contribute to the onset of a heart attack and heart disease so try to relax and deal with your pent up emotions for your heart’s sake.

HEART ACTION PLAN
• Consult your doctor if you have tightness or pain in your chest or pains in your arms and neck
• Call an ambulance if the pain is crushing
• Watch your weight and eat plenty of fresh fruit and vegetables
• Reduce your intake of fatty foods and eat less saturated fats, watch your cholesterol levels
• Eat more fish, and poultry minus skin Tell your doctor is you experience depression, panic or erratic heartbeat
• Stop smoking
• Take more exercise aim for 30 minutes activity each day
• Cut out excess salt from your diet
• Discuss with your GP the risk of CHD if you are on the contraceptive pill
• Consider taking vitamin supplements (ACE vitamins)
• Don’t drink excessively
• Discuss taking a low dosage of aspirin with your GP if you already suffer from CHD
• Consider hormone replacement therapy to protect you from CHD
• Learn to relax

CONTACTS
British Heart Foundation
http://www.bhf.org.uk
British Cardiac Patients Association
http://www.bcpa.co.uk