Overview

It is a common misconception that heart disease is a “man’s problem”. The focus of research, prevention, and treatment efforts also has primarily been on men. Studies and data from recent years have revealed that women in India are also at significant risk of heart disease. This may surprise many, but heart disease is increasingly becoming a leading cause of death among women in India. So, it is time to shed light on this silent threat.

Pertinent Facts About Heart Disease in Women

Heart disease is a broad term that encompasses several conditions. The conditions most people know about are coronary artery disease and heart attacks, which are the formation of blockages in the arteries of the heart, reducing the supply of oxygen and nutrients to part of the heart muscle. Other heart diseases include heart failure, wherein the heart muscle weakens, and arrhythmias, which are heart rhythm abnormalities.

Risk Factors of Heart Disease in Women

Risk factors such as high blood pressure, high cholesterol, smoking, obesity, lack of physical activity, diabetes, and a family history of heart disease can increase the likelihood of developing heart disease.

In India, heart disease is responsible for approximately 25% of all deaths, and women account for a significant portion of these deaths. According to the Global Burden of Disease Study, heart disease is the leading cause of death among women in India, accounting for almost 18% of all female deaths. Shockingly, the mortality rate due to heart disease among Indian women is higher than that of breast cancer and other cancers combined. According to studies published in the Journal of the American College of Cardiology, the prevalence of coronary artery disease in Indian women ranges from 3% to 13%, depending on the age group. It has increased by almost 300% over the past two decades, and the prevalence of heart failure in women in India has more than doubled from 1.1% in 2000 to 2.6% in 2015. The mean age of heart attack in Indian women is 59 years, much lower than the average age of heart attack in women in developed countries. These data highlight the urgent need to raise awareness about heart disease in women and address the unique risk factors that affect them.

Factors Contributing to Heart Disease in Women

Several factors contribute to the increased risk of heart disease in women in India.

One key factor is the high prevalence of risk factors such as high blood pressure, high cholesterol, and diabetes among women. The prevalence of diabetes, in particular, appears to be higher in Indian women than women in other countries (approximately 12% versus the global average of 9%, according to the Demographic and Health Surveys Program and International Diabetes Federation). It is important to note that diabetes is a complex condition influenced by various genetic, environmental, and lifestyle factors. Indian women often face unique challenges such as lack of physical activity, poor nutrition, and increased stress due to societal and cultural norms, which can contribute to developing risk factors for heart disease. Additionally, hormonal changes during pregnancy and menopause can impact a woman's cardiovascular health.

Conditions like diabetes during pregnancy (gestational diabetes) and hypertensive disorders during pregnancy (preeclampsia and gestational hypertension) can increase the risk of heart disease. Several studies have reported that compared to women from other countries, Indian women have a higher prevalence of gestational diabetes (17% versus 6-9% in the United States), preeclampsia (6-7% versus 4-5%) and gestational hypertension (10-11% versus 5-6%). The risk of heart disease in women increases significantly after menopause, and menopause at a young age is an additional risk factor for heart disease.

Another challenge in addressing heart disease in women in India is the lack of awareness and knowledge about the condition. Heart disease symptoms in women can differ from those in men, and women often experience subtle or atypical symptoms, such as tiredness, dizziness, nausea, acidity, stomach upset or shortness of breath, which may be easily overlooked or attributed to other causes. This can lead to delayed diagnosis and treatment, resulting in poorer outcomes.

Moreover, societal norms and cultural beliefs may discourage women from seeking timely medical attention or discussing their health concerns openly, leading to underdiagnosis and undertreatment of heart disease in women. Women are often the caregiver for their families and ignore their health concerns to take care of others. Studies have shown that women are more likely to have delayed presentation of heart attacks, experience more delay in receiving the correct diagnosis, receive less guideline-recommended treatment, and consequently have poorer outcomes following a heart attack.

Furthermore, there are significant disparities in access to healthcare for women in India, particularly in rural areas. Many women face challenges accessing quality healthcare, including cardiovascular screening, preventive care, and timely treatment. This lack of access to healthcare services further exacerbates the burden of heart disease in women.

Addressing Growing Heart Disease Concerns in Women in India

A multi-faceted approach is needed to address the growing issue of heart disease among women in India. First and foremost, there is a need to raise awareness about heart disease and its risk factors among women, their families, and healthcare providers. Educational campaigns, community programs, and media campaigns can be used to disseminate information about the unique aspects of heart disease pertaining to women. Women should be educated about the importance of maintaining a healthy lifestyle, including regular physical activity, healthy eating habits, avoiding tobacco use and exposure to secondhand smoke, and managing stress.

Addressing barriers to adopting healthy lifestyles is also required. Tailored interventions are needed, such as promoting physical activity through culturally appropriate means, providing access to healthy and affordable nutrition, and managing stress through strategies like mindfulness, meditation, and social support. Access to healthcare services can be achieved through initiatives such as mobile health clinics, community health programs and insurance schemes. Screening and aggressive management of risk factors such as high blood pressure, high cholesterol, diabetes and obesity are needed, particularly in those with a family history of heart disease. Most importantly, empowering women to take control of their cardiovascular health is essential. This includes promoting gender-sensitive healthcare, encouraging women to be proactive about their health, and promoting self-advocacy. Women should be encouraged to seek medical attention promptly for any concerning symptoms. Healthcare providers should also be trained to recognise the unique symptoms of heart disease in women and provide appropriate care. Providers should listen to and address women’s health concerns with empathy and respect. Lastly, collecting gender-specific data on heart disease and its risk factors among women in India is crucial to understand the burden, trends, and challenges associated with heart disease in women, which can guide evidence-based interventions and policies.

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When to Consult a Doctor

You can also get in touch with the expert cardiology doctors at Narayana Healthcare based in your city to get immediate attention and medical support during injuries, health disorders or any other health concern.

Conclusion

In conclusion, reducing heart disease in women in India requires a comprehensive approach that addresses awareness, healthy lifestyles, risk factor management, unique challenges, healthcare access, empowerment, and research. By implementing these strategies, we can empower women to take control of their cardiovascular health, reduce the burden of heart disease, and improve the overall health and well-being of women in India. It is time to recognise and address the silent threat of heart disease among women and work towards a healthier future for all.

FAQs about Heart Disease in Women

Q. What is the leading cause of death in women in India? A. According to the Global Burden of Disease Study, heart disease is the leading cause of death among women in India, accounting for almost 18% of all female deaths.

Q. What is the prevalence of Coronary Artery Disease in India? A. According to studies published in the Journal of the American College of Cardiology, the prevalence of coronary artery disease in Indian women ranges from 3% to 13%, depending on the age group. It has increased by almost 300% over the past two decades, and the prevalence of heart failure in women in India has more than doubled from 1.1% in 2000 to 2.6% in 2015.

Q. What are the risk factors for heart diseases in women? A. Conditions such as diabetes during pregnancy (gestational diabetes) and hypertensive disorders during pregnancy (preeclampsia and gestational hypertension) can increase the risk of heart disease. Several studies have reported that compared to women from other countries, Indian women have a higher prevalence of gestational diabetes (17% versus 6-9% in the United States), preeclampsia (6-7% versus 4-5%) and gestational hypertension (10-11% versus 5-6%).

Q. How does menopause affect heart diseases in women? A. The risk of heart disease in women increases significantly after menopause, and menopause at a young age is an additional risk factor for heart disease.

Published by Dr. Aditi Singhvi