Cardiovascular disease (CVD) is the leading cause of morbidity and mortality among both men and women worldwide. However, women have exclusive risk factors connected to their reproductive histories that are unlike those of men. Women’s heart attack symptoms are often distinct from men, and they’re much more probable than a man to die within one year after an attack.
Additionally, women tend to react worse than men when using clot-busting drugs or undergoing various cardiac medical procedures. For postmenopausal women, cardiovascular disease (CVD) and osteoporosis are the two most frequent pathological conditions. Let’s go ahead and look at the specific risk factors for women.
Risk Factors for Women with Heart Disease
The primary risk factors for heart disease in women are similar to those for men — such as high blood pressure, diabetes, and smoking — but there are a few additional factors that can put women at higher risk. These include a family history of heart disease, obesity, being over the age of 55, having an unhealthy diet or sedentary lifestyle, and hormonal changes associated with pregnancy and menopause.
Women also tend to experience different symptoms than men when it comes to heart disease. This means that their condition may go undetected until it becomes more serious. Common symptoms in women include unusual fatigue, shortness of breath, chest discomfort or pain, nausea or vomiting, back pain or jaw pain. It is important for women to be aware of these symptoms so they can seek medical attention if needed.
Let’s go through in detail about two broad risk factors that affect women.
Gynecology Risk Factors
Polycystic Ovary Syndrome
PCOS is a highly common disorder among women of childbearing age. It includes enlarged and micro-polycystic ovaries, along with clinical features caused by endocrine and metabolic alterations from the hypothalamic-hypophyseal-ovary-adrenal axis to adipose tissue. Psychosocial, reproductive, and metabolic abnormalities are all linked to PCOS syndrome in some way or another.
Common signs of PCOS include menstrual imbalances such as oligomenorrhea, amenorrhea, and metrorrhagia as well as infertility. The condition is further characterized by hyperandrogenism in 60% of cases with hirsutism, acne, alopecia or obesity present in half the population impacted by it. In some phenotypes this is associated with insulin resistance (IR) accompanied by increased levels of circulating insulin which can worsen the symptoms related to hyperandrogenism creating an ongoing cycle that aggravates disease progression.
In patients with PCOS, visceral obesity can cause the production of pro-inflammatory cytokines which leads to subclinical inflammation and heightened free radical production. The combination of these factors causes a synergistic effect that activates the endothelium resulting in increased intima-media carotid thickness and preclinical atherosclerosis, particularly among young women.
Women with PCOS and a high body mass index (BMI) are twice as likely to be at risk of cardiovascular disease (CVD). Furthermore, this is not an insignificant contribution. PCOS alone can initiate its own causal effect on CVD, increasing the chances of coronary heart disease (CHD) and stroke.
What’s more, PCOS is a major source of infertility and miscarriages. According to recent studies, the percentage of women with PCOS who experience miscarriage fluctuates between 30-50% while only 10-15% of healthy women do so. This has also been linked to future cardiovascular diseases (CVD).
Premature Ovarian Failure
Premature ovarian failure (POF) or ovarian insufficiency, otherwise known as early menopause, is present in approximately 1% of women before the age of 40. This female reproductive disorder has been linked to an increased risk for cardiovascular diseases. Medical research and studies have determined that when POF sets in earlier, it may result in more adverse clinical outcomes associated with CVDs than if onset was later on.
Numerous studies have demonstrated that premature ovarian failure (POF) can result in psychological anguish, infertility, brittle bones, autoimmune problems, coronary heart disease (IHD), and a heightened chance of early death. The decrease in estrogen levels associated with POF is linked to atherosclerosis, high cholesterol levels, as well as cardiac ailments. By recognizing women who experienced an earlier menopause onset, interventions may be initiated to help improve cardiovascular health during the postmenopausal period.
Menopause
Menopause is a well-known risk factor for cardiovascular disease (CVD). Without the protective benefits of endogenous oestrogens, women experience CVD later in life than men – often after they reach menopausal age. The timing of when this transition occurs can have an influence on whether or not one develops CVD and/or its associated risks. Those who enter early menopause are more likely to suffer from it than those whose onset takes place at a later stage.
An inadequate level of hormones can disrupt the workings of various organs and systems, such as the central nervous system, endothelium, bones and liver. Menopause is accompanied by a major alteration in lipid profiles with an increase in total cholesterol levels, LDL-cholesterol and triglycerides while HDL-cholesterol drops substantially. This proatherogenic shift may lead to significant health consequences if not properly managed.
On top of this, menopause can cause a shift in fat storage, resulting in visceral adiposity and decreased insulin resistance. This change puts women at higher risk for diabetes development as well as worsening metabolic syndrome.
Surgical Menopause
Research suggests that women who undergo surgical menopause are at greater risk of early death, cardiovascular and osteoporosis diseases, cognitive decline and dementia, Parkinsonism, psychological distress as well as sexual dysfunction. Moreover, those aged 46 or younger when having their ovaries removed were found to be more vulnerable to depression symptoms in addition to hyperlipidaemia issues such as cardiac arrhythmias or coronary artery disease along with arthritis inflammation, asthma attacks and chronic obstructive pulmonary disorder complications plus an increased susceptibility for bone loss.
Even with certain variables like ethnicity, BMI, education level, smoking habits and age taken into consideration—the risk of morbidity significantly increased. However, women who used oestrogen therapy experienced reduced effects from these associations.
Obstetric Risk Factors
Pregnancy Complications
Pregnancy can lead to an increase in weight and metabolic syndrome. During normal pregnancy, the coagulation system shifts towards hypercoagulability which is designed to reduce blood loss at delivery. However, this increases thrombosis risk by up to four times for pregnant women. Additionally, more births have been linked with higher rates of CVD than those without any childbirth history. Nulliparous women tend to have a lower prevalence of cardiovascular disease compared to mothers who gave birth before them.
Pregnancy is a unique “metabolic stress test” for women, and failing to pass it can be an indication of future cardiovascular disease. Consequently, pregnancy offers us the chance to identify those who are at higher risk of CVD early on so that preventive measures may be administered as soon as possible.
Gestational diabetes mellitus
GDM can have a detrimental effect on future glucose tolerance and may even lead to T2DM, metabolic syndrome, and cardiovascular disease. Women with a history of GDM are more likely to be diagnosed with metabolic syndrome which includes an abdominal obesity diagnosis, lower HDL concentrations levels, elevated LDL-cholesterol and triglyceride levels as well as increased C-reactive protein rates. All these factors significantly increase their risk of developing CVD later in life.
Women with GDM are more likely to suffer from CAD and/or stroke than other populations, often at a younger age. Furthermore, research has shown that GDM is linked to angina pectoris, MI and hypertension even if the individual does not have T2DM.
Preeclampsia
Preeclampsia is typically diagnosed in pregnant women when an initial systolic blood pressure recording of at least 140 mmHg and/or diastolic blood pressure reading of 90 mmHg or higher is confirmed by two repeat readings. 6 to 8% of all pregnancies are reported as suffering from some form of hypertensive disorders, with proteinuria beginning around the 20th week for those previously considered normotensives before pregnancy.
Women with preeclampsia have a significantly elevated 11.6 times risk of developing arterial hypertension in comparison to healthy women, making it an important prognostic factor for future cardiovascular disease (CVD). Of all pregnancy complications, preeclampsia appears to be more closely associated with classic CV risks than any other.
Preterm Birth
Preterm birth (PTB), or delivery of a baby before 37 weeks gestation, affects an astounding 11% of all pregnancies. Unfortunately, PTB is the leading cause of long-term neurologic disabilities in children and death among infants worldwide. It not only puts the life and well-being of your baby at risk, but it can also be indicative that you are more likely to have cardiovascular events later on in life as well as increased hospitalization rates.
Miscarriage
Research has revealed a link between repeated miscarriages and the emergence of cardiovascular disease (CVD) symptoms, as well as other risk factors. Women with such a history are more prone to CVD-related events, hospital admissions for CVD treatment, and even CV diagnostic procedures than those without them.
Prevention Strategies
While it’s true that some risk factors cannot be controlled, there are many steps you can take to reduce your risk of developing heart disease. Eating a healthy diet low in saturated fats and exercising regularly can help keep your cholesterol levels low and your weight under control. Avoiding smoking and limiting alcohol consumption can also have positive effects on your cardiovascular health. If you have any pre-existing conditions such as diabetes or hypertension, make sure to monitor them closely by visiting your doctor regularly and taking any prescribed medications as directed.
