Healthy Town: Women need to understand their heart health

Dr Angie Brown, consultant cardiologist and medical director of the Irish Heart Foundation, says although everyone needs to look after their health, there are differences between men and women.

“When it comes to heart health, women tend to be protected by their hormones but they catch up with men after the menopause when cholesterol levels rise and the blood pressure goes up,” she says. “Women therefore tend to present a few years later but have just as much heart disease. So if a woman has the traditional risk factors for heart disease it is very important they are checked and treated.

“And ageing is a risk factor for developing heart disease and stroke. Sometimes older patients have fewer symptoms or may not realise they have them as they assume they are slowing up or getting breathless because they are getting older. So anyone who has any concerning symptoms should seek medical advice from their doctor.”

As with their male counterparts there are certain lifestyle issues which affect the female heart and over the course of the Pfizer Healthy Towns initiative in Wexford, residents will have been learning how to look after their hearts, both now and in the future.

Janis Morrissey, head of Health Promotion, Information and Training at the Irish Heart Foundation, says while the same health advice applies to both men and women, there are some areas where women need to be more aware.

“Factors such as smoking, being overweight or obese, having high blood pressure, high cholesterol, being inactive or having diabetes and a family history of cardiac problems increases the risk of heart attack and stroke for everyone,” she says. “But in many cases women are even more vulnerable to these factors than men.

“For example, women metabolise nicotine a lot faster than men, so a cigarette will increase a woman’s risk a lot more than it will in a man. The same with diabetes - it increases a woman’s risk of having heart disease a lot more than it will for a man. Another risk factor that’s more important for women is family history of heart disease, which can be a stronger predictor in women than in men.

“And about one third of all women in Ireland will die of cardiovascular disease. Yet many still view a heart attack as mainly being a man’s problem rather than being an issue for them too. And more women than men die from stroke.”

A survey conducted by the Irish Heart Foundation in 2015 found that only one in four women knew that as women get older, menopause increases risk of heart disease and stroke.

Dr Angie Brown explains the different types of symptoms and advises on when women should seek advice.

Heart failure symptoms can vary and depend on the cause but the main symptoms are breathlessness and swelling of the ankles

“Women may have different symptoms to men and tend to ignore them so it’s important that they see their GP and have a full risk assessment and further investigations as appropriate,” she says. “But in general ischaemic heart disease can cause chest pain, back pain, pain in the left shoulder and arm, sometimes neck pain, breathlessness, palpitations and dizziness.

“Heart failure symptoms can vary and depend on the cause but the main symptoms are breathlessness and swelling of the ankles. It may cause people to wake up at night breathless and be unable to lie flat in bed. People with heart failure may have palpitations and are more likely to develop atrial fibrillation (AF), which is an irregular pulse.

“And people with atrial fibrillation may have no symptoms or can suffer from dizziness, palpitations and breathlessness. They may also feel tightness in their chest and occasionally might have blackouts.”

The cardiac specialist says people should seek medical advice if they are experiencing any of the symptoms of heart disease. Everyone should also have their blood pressure, cholesterol and blood sugar checked and should strive to be more active, eat a healthy diet, stop smoking, reduce alcohol and be aware of family history.

Dr Cliodhna Foley Nolan, medical director of safefood.eu says when it comes to heart health, eating well is vital for both sexes.

Heart disease begins in childhood so a heart-healthy diet needs to begin from day one

“Heart and circulatory disease is still the number one cause of death in Ireland; it is associated with obesity, high blood pressure and smoking,” she says. “But while there are differences in the risks for cardiovascular disease between men and women, there is no evidence of difference due to diet.

“Heart disease begins in childhood so a heart-healthy diet needs to begin from day one. Dietary advice includes some don’ts (high fat and high-sugar foods) but the positive heart health message is to increase our fruit and veg intake. Half the dinner plate should be covered with vegetables. We need to greatly increase our intake of fruit and vegetables; start by adding one more piece than usual per day and build up to at least five a day.”