Cardiovascular diseases are the number one killer of women, causing one in three deaths each year. Since symptoms of heart attack tend to be different from men’s, women might be diagnosed less often with heart diseases.
This was shared in an awareness symposium on heart diseases ‘Go Red for Women’ at Aga Khan University. Experts shed light on the many myths attached to heart diseases in women. Cardiovascular diseases have conventionally been considered as a ‘man’s disease,’ when in reality it is the leading cause of death for both men and women in Pakistan, experts said.
At present, more than 80 per cent of cardiovascular deaths occur in low-and middle-income countries. In Pakistan, the number of people, especially young people, dying due to cardiovascular diseases is on the rise. More than 1100 people are losing their lives daily due to heart attacks, according to National Institute of Cardiovascular Diseases (NICVD). Pakistan has committed to reduce the burden of heart diseases by a third by 2030 under goal 3 of the sustainable development goals.
Women, in particular, don’t always recognise their symptoms as those of heart attacks. The symptoms, often unrelated to chest pain include neck, jaw and shoulder discomfort, nausea or vomiting, shortness of breath, dizziness, indigestion, and unusual fatigue.
Risk factors that are more potent in women include high blood pressure, diabetes, physical inactivity, high-risk dietary patterns and psychosocial stress. Other non-traditional risk factors are related to stress, depression, menopause and polycystic ovarian syndrome. “About a third of our adult populations has three or greater risk factors,” said Dr Zainab Samad, professor and chair of department of medicine.
Similar to heart attack and cardiovascular diseases, rheumatic heart disease is also a point of concern for women. The disease, emanating from strep throat and high fever can cause damage to heart valves and result in heart failure. Less than one per cent of cases occurs in high-income countries, with the major burden on low and middle-income countries.
Pakistan faces a high prevalence of rheumatic heart disease (6 per 1000) with a 66 per cent occurrence in women in comparison to men. “Women who have RHD are younger, poorer, and have worse morbidity and outcomes than men,” said Dr Saira Bukhari, assistant professor at the department of medicine.
The experts also talked about cultural constraints and lack of agency in women inhibiting them to step out of the house to seek medical help, resulting in late appearance at the emergency room.
According to a study conducted in Uganda, East Africa, women of childbearing age who suffer from RHD in low-to moderate-income countries face a double danger: increased risk of complications during pregnancy and also the societal burden and expectation to be mothers. Dr Bukhari pointed out the cultural pressures women face to bring an offspring to the world, often at the cost of their own heart health. “The perception is such that women are not taken seriously and the symptoms are perceived to be psychological and not medical among families,” said Dr Bukhari.