Because women’s hearts are more at risk

The heart attack? 68% of the female population thinks that this is a male “prerogative” (data from the Monzino Cardiology Center in Milan). And, instead, this is not the case at all: in Italy, every five minutes a woman is the victim of a heart attack or another cardiovascular disease. If women are protected enough at childbearing age, they have a higher risk of developing heart problems after menopause than men. And often, in a more severe form. To say it, once again, the numbers: cardiovascular disease is the number one cause of mortality for women after the age of 50, far exceeding all forms of cancer, including the much feared breast cancer.

Precisely to raise awareness among women on this issue, on February 5, the World Day Against Female Heart Diseases is celebrated around the world.

But for what reasons do women have such a fragile heart? First of all, why the classic risk factors for cardiovascular disease (hypertension, diabetes, high cholesterol, family history, metabolic syndrome, smoking, poor diet, sedentary lifestyle) they do not have the same effects in both sexes. For example, high blood pressure appears to be more harmful in women, as does smoking, so much so that a woman who smokes 10 cigarettes is comparable, for effects on the heart and arteries, to a man who smokes 30.

The second reason is that there are also exclusively female risk factors. “These are some pathologies of gynecological, endocrinological, immunological and oncological relevance which, if not recognized as such and kept under control, after menopause can favor the onset of cardiovascular diseases” explains the doctor Daniela Trabattoni, cardiologist and Head of the Monzino Women Center, the first Italian center entirely dedicated to the prevention and treatment of the female heart. The main ones? Spontaneous multiple abortion, premature births, polycystic ovary, thyroid disease, diseases such as rheumatoid arthritis and systemic lupus erythematosus, radio and chemotherapy for breast cancer.

The psychological aspect also contributes to the definition of cardiovascular risk in the female world. Several studies indicate that stress, anxiety and depression do not pose equal danger for both sexes. “In women, in conditions of prolonged stress, the coronary arteries, instead of dilating and allowing a greater flow of blood to the heart, shrink, obstructing blood flow and resulting in ischemia or myocardial infarction in the absence of atherosclerotic plaques: it is the sindrome di Takotsubo, better known as broken heart syndrome»Explains the expert. Never underestimate, therefore, mood and psychological disorders, so common in women, even more so in the era of Covid-19. A strong emotion, a tearing pain, a grief, a great fear: these are all elements that lead their heart to suffer.

WHEN TO GET CHECKED?
The ones listed above are very important spies in terms of prevention: in fact, they signal that the heart needs some extra attention before the damage is too great. “A woman who has one or more of these risk factors and perhaps smokes, is overweight, is familiar with heart disease, moves little and / or eats poorly should not wait for symptoms: it is better that she undergo a checkup too. if he is well, so as to identify his individual cardiac risk profile »advises the cardiologist. This way he can understand if and what habits he needs to change to protect his heart. The Monzino Women case series confirms the validity of early screening: of the more than 700 healthy women who came to the center for a checkup, 25% found they had a high risk profile, such as to make it necessary to resort to therapy or lifestyle corrections.

NEVER WAIT TOO MUCH
Unfortunately, however, women are reluctant to seek medical attention. Not only do they not do it when they are apparently well, but not even when they feel bad: partly because they think they are more protected than men, partly because you are used to enduring various ailments and ailments, partly because they are more likely to take care of others than of themselves, often, they tend to ask for help only when the situation is already serious (and unfortunately the Covid-19 pandemic is aggravating things). Also for this, according to statistics, in the year following the first heart attack, 35% of women suffer another heart attack and 38% lose their lives, while in men these percentages are decidedly lower, respectively equal to 18% and 25%. “If you act within six hours of heart attack symptoms appear, the chances of recovery are good. Once this threshold is exceeded, the damage to the heart muscle is more extensive and irreversible, with increased arrhythmic complications and worse outcomes ”, says Trabattoni.

THE ALARM BELLS
But what are the first signs? Not just the classic ones, such as chest and arm pain. In women, the symptoms of an acute cardiac event may also be more nuanced and less characteristic. Here are the main ones:
– tiredness and fatigue that do not even pass at rest;
an inexplicable general malaise,
-the feeling of having a weight on the stomach, perhaps in association with nausea;
-a pain that radiates to the back, neck, jaw;
– cold sweating;
breathlessness and shortness of breath at rest.

The female heart is also more disadvantaged from the point of view of care. It is a fact that the vast majority of drug studies have been conducted in men. “But, as we have partly seen, women are not the same as men: they have different risk factors, a lower weight and body mass index, thinner and more tortuous coronaries, just to name a few differences,” says the expert.

Various researches also document substantial differences in the posology of life-saving drugs prescribed to women, which are often under-treated: for example, in their case, statins (cholesterol drugs) are not given at full dosage after a heart attack for fear side effects and the belief that less active ingredient is enough for them. Yet the treatments and therapeutic tools available are many: drugs, coronary angioplasty, stents, coronary artery bypass grafting, the so-called “heart-saving umbrella” that prevents clots from the heart to the brain, implantable subcutaneous defibrillators. It simply takes more attention and awareness from everyone.