Heart Health 101 – What are the differences between men and women?

The Heart and Stroke Foundation South Africa says 225 South Africans die of heart disease every day and 10 South Africans suffer a stroke every hour.

According to data published on healthdata.org, the main risk factors that caused the most deaths in South Africa (2019) include unsafe sex, malnutrition, elevated body mass index (BMI), high fasting blood sugar, blood pressure high, tobacco, alcohol consumption, air pollution and food risks.

With these factors in mind, the topic of heart attacks and cardiovascular disease is inevitable as many of these impact your heart health.

The difference between a stroke and a heart attack

While both strokes and heart attacks result from a lack of blood flow to critical parts of the body, a stroke is caused by a blockage of blood flow to the brain, and a heart attack is caused by a blockage of blood flow to the heart. (tricitymed.org)

heart health
heart health Image: iStock

What are the differences between men and women?

Although most of the symptoms are similar for men and women when it comes to strokes and heart attacks, Dr. Chevaan Hendrickse, an interventional cardiologist at Life Vincent Palloti Hospital, Life Kingsbury Hospital, and Mediclinic Constantiaberg, says there are slight differences.

According to him, women are more likely to have atypical symptoms such as shortness of breath, gastritis and discomfort. It is also interesting to note that cardiovascular deaths are higher in women than in men.

Dr. Hendrickse says that although patients may have symptoms and signs, it is actually the microcirculation within the heart that is more important than what is seen on an angiogram.

“The heart has several layers of blood vessels. Some can be seen, others not ”.

According to Dr. Hendrickse, it is mainly the risk factors that cause the differences between men and women when it comes to cardiovascular disease. Although smoking, obesity, high BMI, little exercise, a sedentary lifestyle, smartphones and computers are all seen as risk factors for both men and women, there are some modifiers in the female system which tend to make women more susceptible to heart disease.

READ: Heart attacks increasingly affect younger men

Risk factors and their effects

HRT during menopause is currently a hot topic when it comes to heart disease among women, as it could increase the chances of developing cardiovascular disease.

Contraceptives based on estrogen and progesterone have been linked to patients experiencing lipid abnormalities, putting them at risk of developing hypertension.

Although the benefit of contraceptives is termination of pregnancy, it also comes with common patient concerns including weight gain, mood swings, cardiovascular risks, and future fertility.

cardiovascular disease
cardiovascular disease. Image: iStock

Women looking into menopausal HRT (normally around age 51) should also consider the risks first and consult a doctor regarding the best individual approach.

Dr. Hendrickse says doctors shouldn’t simply “distribute these hormones” and that there has been a decline in the use of HRT due to the risk of heart disease.

While research is ongoing on the subject, it suggests estrogen-only therapy as this has been associated with fewer cardiovascular events.

According to Dr. Hendrickse, preeclampsia also has an effect on cardiovascular disease as it has implications for blood vessels in several organs, including the heart. “A ruptured placenta is also associated with cardiovascular risk,” he says, as is spontaneous pregnancy loss.

Breast cancer is also a cause for concern when it comes to heart disease, especially in women, with high mortality among women with breast cancer, over the age of 65. Dr. Hendrickse says he found that this is often the case with ethnic black women and those with left-sided tumors who end up receiving radiation in that side of the chest.

“The heart is just in the way,” he says, “and the ships are damaged.”

Breastfeeding has been associated with reduced cardiovascular risks. A study published in the Journal of the American Heart Association found that breastfeeding benefits not only babies, but mothers as well, by reducing the risk of various health problems, including breast and ovarian cancer, type 2 diabetes, and heart disease.

The study took place over a 10-year period and found that women who were breastfeeding had an 11% decrease in cardiovascular events, a 14% decrease in coronary heart disease, a 12% decrease in strokes, and a 17% decrease in fatal cardiovascular events.

According to the researchers, there are several theories on the link between breastfeeding and cardiovascular risk. One theory considers the important role hormones play during breastfeeding. The other attributes cardiovascular risk to how a woman’s maternal metabolism is restored with breastfeeding.

What about the heart health of young people?

Younger individuals who are at risk for cardiovascular disease normally have it in their genes. If grandma or grandfather suffered cardiac arrest at age 50, that is a powerful risk factor, says Dr. Hendrickse.

He also points out that smoking has become a fairly high risk factor among the younger generation, referring to the recent admission of a 29-year-old smoker with a family history of heart disease who had a “full-blown heart attack”.

According to the World Health Organization, cardiovascular disease is the leading cause of death globally and therefore it is important to know the risk factors and how to take care of your heart.