Women and coronary artery disease

Cardiovascular disease (CVD) is the foremost cause of morbidity and death, accounting for 30 per cent of all deaths,” says Dr Aparna Jaswal who is a cardiology and electrophysiology specialist with an expertise in the ablation of various complex arrhythmias, implantation of pacemakers, implantable cardioverter- defibrillators, cardiac resynchronisation therapy and implantable CRT defibrillators.

 Dr Jaswal received distinctions in biochemistry, pharmacology and ENT in her MBBS examination; was awarded the Pinnamineni Venkateswara Rao Gold Medal for the best out-going student for the year 1992-93 from the Andhra Pradesh University of Health Sciences; the Dr Wazir Gold Medal for the best student for the year from the Diplomate of National Board 2003; the Distinguished Service Award from the Indian Medical Association – Academy of Medical Sciences 2007-08; the Prof DP Basu Memorial Award CSI 2014 and more.

 According to Dr Jaswal CVD may be caused bya number of factors ranging from high blood pressure, smoking and diabetes to lack of exercise, obesity and excessive alcohol consumption. While economic globalisation is what we all desire it brings along with it stressors that produce chronic biologic arousal and promote unhealthy behaviours thus increasing cardiovascular risks, she says.

 It is estimated that while 30 per cent of women die of coronary artery disease (CAD); yet, about 70 per cent of university educated women consider their risk to be less than one per cent. “This lack of concern for CAD by women and perhaps their physicians explains why the need to discuss this further,” she says going on to explain that it has been proved that women have a poorer outcome than men aftera heart attack or a cardiac bypass surgery. They are even more likely to die aftera heart attack and also suffer more heart failure.

 Women havinga heart attack are more likely to present with atypical chest pain (mid-back pain) and atypical symptoms (indigestion, nausea, vomiting and breathlessness).

 The reason that women become so prone to heart disease is that during their youth they are protected by the hormones and the opposite is true as they get older. The failure to treat women as vigorously as men contributes to their worse outcomes. “It is well known that the modifiable risk factors such as obesity, hypertension, diabetes and dyslipidemia are the same in both sexes and should be identified and treated early. Increasing the consumption of fruits, vegetables, nuts, fish and fibre along with a reduced intake of saturated fats are the dietary ingredients to a healthy heart,” says Dr Jaswal.