The risk factors for cardiovascular disease tend to emerge about 10 years earlier in men compared to women. This is because of the influence of the testosterone hormone, which can cause an increase in heart rate, blood pressure, and muscle mass, and it is pro-atherogenic compared to estrogen.
Estrogen, on the other hand, can cause high HDL cholesterol and low LDL cholesterol. “It is also a vasodilator and helps in endothelial function, thus producing less atherosclerosis in females. But this benefit occurs only up to menopause, and once menopause sets in, the gap between males and females narrows," said Dr Sandeep R, interventional cardiologist at Aster Medcity, Kochi. Within 10 years from the onset of menopause, the probability of heart diseases in both sexes becomes almost the same.
According to Dr Deepak Davidson, interventional cardiologist at Caritas Hospital, Kottayam, compared to men, the symptoms of heart attacks are atypical in women. Such symptoms include tiredness, giddiness, shoulder pain, and breathlessness. “They tend to have some sort of epigastric — abdominal discomfort, more belching, and back discomfort," he said, adding that common symptoms like chest discomfort are seen in both males and females.
For several social and medical reasons, women may overlook symptoms such as breathlessness, nausea, unusual fatigue or shoulder pain. These symptoms may be attributed to exhaustion, indigestion, stress or other everyday health concerns, particularly when there is no severe chest pain. What many may not realise is that these can sometimes be signs of a heart attack.
Dr Deepak highlighted that quite often these symptoms in women are overlooked as anxiety-related, and the diagnosis of heart disease always gets delayed compared to the diagnosis in men. "Because of the delay in diagnosis, women tend to develop more complications following a heart attack. Often they come to a doctor at an advanced stage," he said.
“Women should take greater care of their health through a healthy diet, regular exercise, and timely screening. Women, families, health workers, and society should all ensure that women’s heart health is given adequate attention,” said Dr Jabir, senior cardiologist at Lisie Hospital, Kochi, adding that irrespective of the gender, identifying cardiovascular risk at an early stage is crucial. “There are tests and screening methods available to assess cardiovascular risk. Indians, due to genetic and other factors, have a higher risk of cardiovascular disease,” he said.