Heart health – what women need to know

With regular heart health checks and some heart-friendly lifestyle changes, here’s how women can protect themselves and reduce their chances of having a heart attack.

Almost every hour, one Aussie woman dies of heart disease. That makes cardiovascular disease – an umbrella term that includes heart disease, stroke and blood vessel disease – the leading cause of death for women, and the biggest health risk women face as they age.

“Though most people believe [the biggest risk for women] is breast cancer, in fact, cardiovascular disease is the leading cause of death for women,” says Natalie Raffoul, cardiovascular risk reduction manager at the Heart Foundation. “There’s a longstanding myth that only men have a high risk of heart disease,” Natalie says.

It sounds scary, but there are many risk factors women can control. Heart health checks are one of the most important preventive measures all Aussies can take.

Women’s heart health

Women at any age, including young women, can be diagnosed with a heart condition, but the risk of cardiovascular disease changes throughout life.

During pregnancy:

While most women will have a normal pregnancy, a small number will have:

• high blood pressure
• pre-eclampsia (high blood pressure, fluid retention and protein in their urine)
• gestational diabetes.

Make sure you discuss your heart health and risk factors with your doctor when planning, and during, your pregnancy.

During menopause and perimenopause:

When women reach menopause (typically in their 40s and 50s), they lose the heart-protective effects of oestrogen as their levels drop, so it’s important to ask your GP or heart specialist if hormone replacement therapy (HRT) may protect your heart.

Compared with men, women’s hearts tend to be smaller, beat faster and shrink a little with age. Though women may develop narrowing of the main arterial highways in their heart, they’re also more likely to develop blockages in smaller blood vessels, which act like little cross streets. This condition is called coronary microvascular disease, or small vessel disease.

“It may not show up when dye is injected into the heart during an angiogram test,” says Professor Diane Fatkin, a molecular cardiologist from the Victor Chang Cardiac Research Institute. The only sign may be very mild chest discomfort when women are stressed or being active through exercise or running for the bus. “The pain is caused by constriction of the heart’s blood vessels,” Prof Fatkin says. “Diagnosis is usually by a process of elimination.”

The best protection against coronary microvascular disease is a healthy lifestyle. “Research shows there are many lifestyle changes women can make to protect their heart and reduce their risk of heart disease and a heart attack,” Prof Fatkin says.

Heart risk factors women can control

The heart is only about the size of a fist, and is a muscle that pumps blood through four chambers via a network of large and small arteries. To stay young at heart at every age, women should adopt these healthy habits.

Eat a heart-healthy diet

“Have plenty of vegetables, eat fruit daily and choose whole grains and unflavoured dairy foods,” says Natalie. “Reduce red meat intake and opt for healthy protein, such as fish and legumes. Prepare home-cooked meals and order less fast food, which is high in fats, salt, kilojoules and sugar.”

Move your body

“Just 30 minutes of moderate exercise a day can protect against heart disease and stroke by helping you maintain a healthy weight and lowering blood pressure and cholesterol levels,” says Natalie.

Check your cholesterol

“Ask your GP how often you should have cholesterol blood tests,” says Natalie. “Women should know their healthy HDL (high-density lipoprotein) cholesterol and unhealthy LDL (low-density lipoprotein) cholesterol and triglyceride levels, too.”

Prioritise your sleep

Less than six hours a night can ramp up your risk of heart disease. Aim for seven to eight hours of sleep a night.

Quit smoking

This lowers the risk of heart problems. Get your partner or flatmate to quit too, as passive smoking is also bad for your heart.

Beat high blood pressure

Reducing salt intake and exercising regularly can help you achieve normal blood pressure of around 120/80. If yours is consistently higher, this can ramp up your risk of heart disease and stroke.

Other heart risk factors for women

Addressing these lesser-known lifestyle factors can also boost your heart health.

Depression

This can trigger inflammatory chemicals, which may damage the lining of your heart’s blood vessels’ walls, making them less flexible. So, if you’re experiencing a low mood 24/7, seek help like counselling and lean in to friends and family for support.

Constant noise

Turn off the TV during dinner, wear noise-cancelling headphones on the bus or train and turn down the ringtone on your phone. People exposed to constant noise have a higher risk of heart issues like irregular heart rhythms and heart attacks.

Snoring

“This has been linked to increased risk of blood pressure and heart attack,” says Natalie. “Talk to your GP about an overnight sleep study for sleep apnoea.” Your dentist can also fit a special mouth guard or splint to change your jaw position to help reduce snoring.

Gum disease

To protect yourself, brush and floss your teeth every day. Sore, bleeding gums can be a sign of unhealthy mouth bacteria, which is linked to inflammation and risk of heart disease. Meanwhile, put on the kettle to enjoy a cup of tea for your ticker – it’s packed with flavonoids that boost heart health and benefit your teeth.

Loneliness

Studies show people who feel more socially connected have lower risk of both heart disease and stroke. So, make sure you are regularly talking to your friends and catch up with them.

Women and heart attacks: what are the signs?

When you think of a heart attack, you might think of someone with arm pain clutching their chest and dropping to the floor. While that can be what happens, some women don’t experience classic chest pain during a heart attack and have other heart attack symptoms, including:

• tightness, pain, pressure or heaviness in their chest, neck, jaw, arms, back or shoulders
• and/or nausea, a cold sweat, dizziness and shortness of breath.
  

Always tell someone how you feel if you’re experiencing these symptoms.

Heart disease isn’t always a bad news story

“One night four years ago, I developed bad jaw pain, pressure in my arms and shoulders and tingling in my hands,” says 53-year-old Nerida Penfold, who helps run her family’s cattle property in Marulan, NSW. “I thought it was due to muscle tension from stress.”

Luckily, Nerida's son arrived home, quickly Googled her symptoms, confirmed she might be having a heart attack and called an ambulance immediately. “In the next few hours, I was given medication to reduce heart muscle damage and a defibrillator kickstarted my heart three times,” she says. “It was terrifying and at times I thought I was going to die. Thankfully, I pulled through and three days later, a stent was put in my heart to fix my blocked artery.”

She adds: “Weeks before my heart attack, I was getting cold sweats and weakness in my arms, which I didn’t realise indicated heart problems. I now belong to a group called Heart Support Australia and see many women who have also had close calls with their heart health. I hassle my girlfriends to have their hearts checked, because it could just save their life.

“After my heart attack I switched to low-fat foods, started eating more vegetables and fish and I started walking every day. Four years on, I have regular cholesterol and blood pressure checks as well as heart-health check-ups twice a year. I have more energy and feel so lucky that the quick actions of my son helped save my life.”

How can I check the health of my heart?

A heart health check can give you important information about your health. During the appointment, your GP will check your:

• blood pressure
• lifestyle habits
• BMI (to see if you’re in a healthy weight range)
• family history of heart disease
• other health conditions or risks you might have.

Based on your risk factors, your GP can tell you how often you need monitoring and follow-up appointments, or tests you may need, including:

• a fasting blood cholesterol test
• fasting blood glucose test to check for diabetes
• other medical checks like an ECG, exercise stress test or tests like an angiogram.
  

It’s best to see your GP in person if you are experiencing any symptoms.

Have you been diagnosed with heart risk factors or heart disease?

It’s never too late to make a positive lifestyle change. Start your journey with The COACH Program^®, a telephone support program provided at no extra cost for eligible^* members with heart conditions or diabetes that can help improve your heart health.

Words by Stephanie Osfield
Publlished December 2022