Everything You Need To Know About Women’s Heart Health

This isn’t your typical online article. We’re not going to tell you how to heal a broken heart with chocolate or a giggle with your girlfriends. In fact, this covers a different type of condition; one where your ticker actually stops functioning – a heart attack.

Women’s heart attacks: The stats

More women are dying of heart attacks than men. Yes, you read that right. “Many people do not realize that women younger than 55 years old are at risk for having heart attacks,” says cardiologist Dr Janet Wei, of the Barbra Streisand Women’s Heart Center, Cedars-Sinai Heart Institute, USA.

“Compared to men, young women suffering heart attacks are more likely to receive delays in treatment; they’re less likely to receive guideline-recommended treatment, and more likely to develop heart failure or die.”

In fact, when researchers from Yale School of Medicine looked at data, they found that women under the age of 50 were twice as likely to die within days of a heart attack if they had one, compared to men.

Compare those statistics to those of breast cancer, which is five times less likely to kill you than a heart attack, and you wonder why there’s not more media coverage of this particular health issue for women.

Consider this: according to the National Centre for Health Statistics in the US, around 11,000 women under the age of 45 were treated in hospital for heart attacks in just one year.

Why are women having more heart attacks compared to men?

So what’s going on? There are many factors at play, one of them being awareness. To begin with, you are not as aware of your heart health and symptoms of a heart attack as a man probably is. It’s not entirely your fault, as most heart attack advice is geared towards men.

In fact, researchers have recently confirmed that women present with different symptoms to men when having a heart attack – a fact that’s rarely covered in heart attack literature and information for the public, or even for doctors.

“Women’s symptoms of an heart attack can be more subtle than those of men, meaning that more women than men may not have a typical, textbook pattern of chest pain,” says Professor Viola Vaccarino, Emory University, USA.

“Women may also present with more symptoms, some of which are not specific to heart disease and could easily be confused with other  conditions (for example, unusual fatigue, difficulty breathing, sense of indigestion, nausea and, in some cases, vomiting).

“Although most women experiencing a heart attack do complain of some chest pain, more often than men they have pain in other locations, like in the upper back, arm, neck, and jaw, which again may confuse their  presentation. With this clinical picture, women may be less likely to suspect heart disease right away.”

What can you do for your heart health?

While the medical establishment catches up, it’s essential that you educate yourself. Around 200,000 women die of heart related issues in the USA each year and, for younger women, the risk of dying if you have a heart attack is even higher – mainly because of lack of understanding and recognition of symptoms. And yet, you probably don’t even know one relatively common symptom of a heart attack for a woman: back ache.

That’s the one you’re training your abs to avoid. We’re also more likely to experience aches or pain in the arms, as well as indigestion and nausea. Chest pain, the classic ‘clutching’ of the chest that we’re often shown in movies and TV shows, is less prevalent in women. In fact, according to research from the Journal of the American Medical Association Internal Medicine, one in five women under 55 who had suffered from heart attacks did not report chest pain.

Another issue for women with attack symptoms is that they’re often treated differently from men by doctors and other medical staff. Research from Stony Brook University showed how diagnoses changed when a woman presented with certain symptoms compared to a man (despite the symptoms being the same and as severe).

Other research undertaken by the Brain Tumour Charity revealed that women’s symptoms are more likely to be dismissed as psychological or attention-seeking and, while that research focused on women patients with brain cancer specifically, there’s no reason to believe the same isn’t true when women present with other symptoms that are common  symptoms of a heart attack.

In fact, research published in the Journal of the American College of Cardiology shows that when women are hospitalized with heart attack symptoms, they are treated less urgently and not given medication as quickly as men.

While diagnosis of the symptoms of heart attacks in women contributes greatly to the higher number of women who die as a result of heart problems, it’s not the only issue. Treatment for heart health is based on decades of research of men, not women, which means you might not get the care you really need.

“Women’s hearts are different from men’s. The hearts are smaller, the arteries are generally smaller, and there are differences in blood flow,” says Wei.

“These differences have implications on the development and diagnosis of heart disease in women. For example, the blood test to diagnose a heart attack has different ‘normal’ levels in men and women (they’re lower in women), and we need to establish sex-specific ranges to improve the sensitivity of this test in women.”

And, says Wei, this infon is just the tip of the iceberg. “The National Institutes of Health have recently required scientists to observe and report sex-based data in biological research,” she says. “Thus, I anticipate the science will reveal both similarities and differences in women and men’s biology and health.”

But I workout, my heart health must be tip top…

Even knowing all this, you might still be thinking you don’t need to worry because you’re not obese, don’t have diabetes, don’t smoke and you work out regularly. The fact is that it’s likely that your training regime isn’t doing as much good for your heart as you think. Why? Because most women are usually focused on weight loss or staying slim.

The problem with going for weight loss as a goal is that gym machines tell you to stick to a steady slower pace to lose weight. The ‘fat-loss zone’ on many machines doesn’t allow your heart rate to exceed 70% of your maximum, which means you’re not giving your heart as powerful a workout as you could. But let’s assume you’re not the kind of gym-goer who takes fitness advice from a treadmill screen – you are reading this magazine, after all!

In fact, let’s assume you’re knowledgeable about weight loss and workouts, and that you’re aware of the benefits that weight training has for helping you maintain the slim physique you’re so proud of.

You know that studies have shown that calories continue to be used up to 36 hours after a weights workout while, with a straightforward cardio workout, this isn’t the case. This is why your gym go-to stations are weights, not stationary bikes or treadmills. You’ve probably got a great body to show for it but, on the inside, your heart may be struggling.

“The heart is a muscle just like any other and still needs to be trained,” says Lisa-Jane Holmes of wildcatfitness.co.uk.

“Cardiovascular endurance has a huge part to play in fitness because it boosts oxygen supply in the blood that, in turn, leads to strength gains, as the body becomes more efficient.

“Having good cardiovascular health will increase stamina, meaning you can exercise harder and for longer, which will of course have countless benefits.

“As with training any muscle, for it to truly get stronger you have to really push, so some of your cardio needs to be maximum effort work like hill sprints rather than steady state like an even-paced 5k jog.”

Is there a workout that can give you a powerful heart as well as the figure you want? There isn’t one workout, but many. Steady-state cardio workouts, high-intensity interval workouts, as well as lifting and also exercises like yoga and Pilates, are all great for your heart. But you can’t do one at the expense of the other.

“While trainers and other experts have recently latched on to interval training as the best way to exercise, the truth is that variety is the key,” suggests Holmes.

“Just as lifting a lighter weight 30 times will produce different muscle power and stamina to lifting a heavier weight 12 times, doing different workouts will make your heart muscles grow in a variety of ways, which is ideal.

“If you keep exercising in the same way, no matter how hard you might be working, your body will start to get used to it and the results will plateau. The more you can keep your muscles (including your heart) guessing, the greater the health benefits.”

Heart health has a lot to do with stress levels, so don’t dismiss the yoga, tai chi or Pilates either. Doing something to reduce stress and refocus might be just as good for your heart. According to research published in the European Journal of Preventive Cardiology, yoga was as beneficial for reducing heart disease risk as brisk walking.

Is my heart literally breaking?

And what about that love element? Well, your emotional state does have an effect on your heart health as, when you go through a break-up, you release cortisol. This not only increases your risk of indigestion and your vulnerability to infection, but it also increases blood flow to your muscles, putting your heart under ongoing stress. This effect is so profound that researchers have even coined a term for it: broken heart syndrome.

It’s no joke – men or women whose partners have recently died are 20 to 35% more likely to die of a heart attack. Unfortunately, aside from swearing yourself off love entirely, there’s not much you can do to protect yourself.

But for now at least, take comfort in this: exercise also helps you get over your emotional heart ache more quickly, so instead of hitting out at love and life, hit the gym.

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