Cardiovascular diseases (CVD) encompass a broad range of issues such as ischemic heart disease, myocardial infarction, hypertension, and heart failure, which can manifest and develop differently in women compared to men.
Female sex hormones, particularly estrogens, have a protective effect on the cardiovascular system until menopause. Estrogens help maintain the elasticity of blood vessels, which aids in preventing atherosclerosis and reducing the risk of heart attacks. However, after menopause, the level of estrogens decreases, which increases the risk of developing CVD. It is also important to note that hormone replacement therapy, sometimes used to reduce menopausal symptoms, can have both positive and negative effects on heart health, which should be carefully evaluated by a doctor.
Symptoms of cardiovascular diseases in women can significantly differ from those in men. For example, women are more likely than men to experience symptoms such as nausea, shortness of breath, fatigue, or abdominal pain, which can lead to an underestimation of the severity of their condition by both the women themselves and medical professionals. This makes diagnosis and timely treatment more challenging.
Cardiovascular diseases are one of the leading causes of death among women worldwide, and this issue worsens with age, especially after menopause. Research and statistical data confirm that nearly one-third of all deaths among women are caused by cardiovascular diseases.
The American Heart Association reports that cardiovascular diseases were responsible for approximately 928,741 deaths in the United States in 2020. Among women under 65, cardiovascular diseases kill twice as many women as breast cancer, and this rate is not decreasing (European Society of Cardiology).
After menopause, women experience a decrease in protective hormones (estrogens), leading to an increased risk of developing atherosclerosis—a condition in which fatty deposits form on the walls of arteries, increasing the likelihood of heart attacks and strokes. Research shows that the incidence of CVD among women becomes noticeable after the age of 50, which often coincides with the age of menopause onset.
Symptoms of Cardiovascular Diseases in Women:
The symptoms of heart disease in women can differ from those in men. Women more frequently report symptoms like fatigue, shortness of breath, and nausea, which are not always clearly associated with heart diseases, leading to delays in diagnosis and treatment. According to studies published in the journal “Circulation,” these differences in symptoms can affect the timeliness of seeking medical help.
Risk Factors for Heart Disease
Hormonal Factors
Hormonal factors significantly influence women’s cardiovascular health, especially the hormone estrogen. This section will delve deeper into how estrogen and other hormonal factors impact women’s cardiovascular system at different stages of their lives.
Estrogen is a steroid hormone that plays a key role in regulating women’s reproductive systems but also has a significant impact on the cardiovascular system. Known for its vasoprotective (protective for blood vessels) properties, estrogen helps maintain the elasticity of blood vessels, allowing them to expand and contract more easily, thereby improving blood circulation. Additionally, estrogen helps to lower levels of “bad” cholesterol (LDL) and increase levels of “good” cholesterol (HDL), reducing the risk of atherosclerosis.
- Influence of Menopause
Before menopause, women’s bodies maintain relatively high levels of estrogen, providing natural protection against cardiovascular diseases. However, with the onset of menopause, there is a significant reduction in estrogen production by the ovaries, diminishing its protective effect on the cardiovascular system. This reduction is one of the reasons why the risk of developing CVD significantly increases in women after menopause.
- Postmenopausal Period
In the postmenopausal period, when estrogen levels remain low, women lose their “natural protection” against cardiovascular diseases. Research indicates that during this period, the frequency of myocardial infarctions and strokes among women sharply increases. Additionally, the stiffness of blood vessels increases, and the risk of their blockage due to atherosclerotic plaques grows.
- Hormone Replacement Therapy (HRT)
One way to manage the risk of cardiovascular diseases in women during the postmenopausal period is hormone replacement therapy, which involves introducing estrogen into the body. However, the use of HRT requires careful consideration of all risks and benefits, as, in some cases, HRT can increase the risk of developing other diseases, including breast cancer and thrombosis.
Specific Risk Factors
Specific risk factors for cardiovascular diseases in women often include conditions that may not be as common or pronounced in men. Particularly, this applies to autoimmune diseases and certain conditions associated with pregnancy. These conditions can significantly increase the risk of developing CVD in women. Let’s explore these risk factors in more detail:
Autoimmune Diseases
- Systemic Lupus Erythematosus (SLE) is a serious autoimmune disease affecting multiple systems of the body, including the skin, joints, kidneys, and cardiovascular system. Women with SLE are at higher risk for developing cardiovascular diseases (CVD) due to chronic inflammation and autoimmune reactions that can damage blood vessels and the heart. Inflammation can promote atherosclerosis, worsen the elasticity of vessels, and ultimately lead to ischemic heart disease.
- Rheumatoid Arthritis (RA) is another autoimmune disease primarily affecting the joints but can also cause systemic inflammatory responses impacting the cardiovascular system. Women with RA are at a higher risk of developing CVD, especially heart failure and atherosclerosis. Inflammation associated with RA can accelerate the process of atherosclerosis and increase the risk of thrombosis.
Pregnancy-Related Risk Factors
- Gestational Diabetes is a condition characterized by elevated blood glucose levels during pregnancy. Women who have experienced gestational diabetes have an increased risk of developing type 2 diabetes and CVD later in life. Diabetes increases the risk of atherosclerosis and other cardiac disorders due to damage to blood vessels.
- Preeclampsia is a condition characterized by high blood pressure and signs of damage to other organs, most often the kidneys, during pregnancy. Women who have experienced preeclampsia have a significantly increased risk of developing hypertension and cardiovascular diseases later in life. Preeclampsia can lead to long-term changes in the vessels and heart, increasing the risk of heart failure and other cardiac conditions.
Genetic Factors
Genetic factors play a key role in the development of cardiovascular diseases (CVD), and having a family history of these diseases significantly increases the risk of their occurrence in women. Knowledge of a family history of CVD can provide valuable information for early diagnosis and the development of effective prevention strategies.
- Impact of Genetics on Cardiovascular Diseases: A family history of CVD often indicates the presence of hereditary factors that can be passed from generation to generation. These factors include genetic mutations that may increase blood cholesterol levels, promote the development of hypertension, or affect other aspects of the cardiovascular system. For example, mutations in genes responsible for lipoprotein metabolism can lead to familial hypercholesterolemia, a condition characterized by very high levels of “bad” cholesterol (LDL), significantly increasing the risk of developing ischemic heart disease.
- The Importance of Knowing Family History: Knowing the family history of CVD enables women and their doctors to make informed decisions about health monitoring and preventive measures. If it is known that there have been cases of CVD in the family, especially at a young age, this can be a signal for earlier and more intensive screening for risk factors such as high cholesterol, blood pressure, and blood sugar. This can also be a basis for early lifestyle changes aimed at reducing these risks.
- Prevention and Early Diagnosis: Women with a family predisposition to CVD should consider regular medical examinations and consultations with a cardiologist. These measures can include:
- Regular blood tests: Checking cholesterol, triglyceride, and glucose levels can help identify early signs of risk.
- Blood pressure monitoring: Regular measurement of blood pressure helps detect hypertension at early stages.
- Lifestyle advice: Recommendations for healthy eating, regular physical exercise, and smoking cessation.
- Pharmacological intervention: In some cases, medication may be necessary to manage cholesterol or blood pressure.
Psychosocial Factors
Psychosocial factors such as stress and depression significantly impact the cardiovascular system, increasing the risks of developing various heart diseases. Understanding the mechanisms of this impact and developing strategies to manage it can significantly improve life quality and reduce the strain on the heart.
Impact of Stress on the Cardiovascular System
Stress triggers a range of physiological responses in the body that can adversely affect the cardiovascular system. Under stress, the release of stress hormones such as adrenaline and cortisol increases heart rate and blood pressure, leading to increased strain on the heart and vessels. Prolonged exposure to these conditions can contribute to the development of hypertension, ischemic heart disease, and even heart failure.
Depression and Cardiovascular Diseases
Depression not only worsens life quality but also has a direct impact on the cardiovascular system. Research shows that depression is associated with an increased risk of heart diseases. One possible reason is the lifestyle changes in people with depression—reduced physical activity, poor diet, and difficulties in adhering to medical recommendations for managing diseases such as diabetes and hypertension, which can also exacerbate cardiac problems.
Effective Management of Stress and Treatment of Depressions
- Techniques like relaxation methods (breathing exercises, yoga, meditation, Tai Chi) can help reduce stress levels and its impact on the heart.
- Regular physical activity not only improves physical health but also helps reduce stress and symptoms of depression.
- Consultations and psychotherapy can assist in developing strategies for coping with stress and treating depression.
- Medication: In some cases, antidepressants or other drugs may be recommended to manage depression and its symptoms affecting the cardiovascular system.
Lifestyle and Preventive Measures
Prevention of cardiovascular diseases (CVD) starts with adopting a healthy lifestyle that includes several key aspects:
- Balanced Diet: A diet rich in fruits, vegetables, whole grains, and low-fat proteins (such as fish and poultry) and limited in saturated fats, trans fats, and salt can help reduce the risk of developing CVD. A diet high in omega-3 fatty acids also positively affects the cardiovascular system.
- Regular Exercise: Physical activity that includes both aerobic exercises (e.g., walking, running, swimming) and strength training strengthens the heart and vessels, helps control weight, cholesterol levels, and pressure.
- Smoking Cessation: Smoking is one of the major risk factors for the development of CVD. Quitting smoking significantly reduces this risk and improves overall health.
- Moderate Alcohol Consumption: Excessive alcohol consumption can lead to increased blood pressure, obesity, and other cardiovascular problems. Moderate consumption may have a protective effect, but it is important not to exceed the recommended limits.
Screening and Diagnosis
Regular medical check-ups and screenings play a crucial role in the early detection and prevention of the development of CVD:
- Blood Pressure Measurement: Regular monitoring of pressure helps detect hypertension, which often occurs without symptoms but significantly increases the risk of cardiovascular diseases.
- Cholesterol Levels Check: High levels of “bad” cholesterol (LDL) and low levels of “good” cholesterol (HDL) can contribute to the development of atherosclerosis. Regular measurement of cholesterol levels aids in early intervention and prevention.
- Blood Sugar Tests: Diabetes is a significant risk factor for CVD. Regular screening for diabetes allows early treatment and condition management.
Individualized Approach to Prevention and Treatment
An individualized approach to prevention and treatment of CVD takes into account the unique aspects of each woman:
- Personal and Family History: Considering family history of CVD helps identify women with a high genetic risk who may need earlier or more intensive preventive measures.
- Age and Living Conditions: Preventive measures and treatments can vary depending on age and living conditions. For example, young women might focus on family planning and managing risks during pregnancy, while older women might focus on managing chronic conditions.
- Individual Risks and Conditions: Each woman has a unique set of risks and health conditions that must be considered when planning medical measures, such as selecting screening methods, treatments, and lifestyle changes.
Using this comprehensive approach to prevention and treatment of CVD in women not only helps prevent the development of diseases but also improves the quality of life over many years.
Understanding the unique risk factors for cardiovascular diseases in women plays a vital role in reducing overall mortality and improving the quality of life. Cardiovascular diseases, long considered mainly a male issue, remain the leading cause of death among women worldwide. Due to biological, genetic, and psychosocial differences between the sexes, symptoms and responses to treatment can vary greatly. Therefore, it is critically important to develop prevention and treatment strategies that take these differences into account.
Regular medical monitoring and screening are essential as they help in early detection of potential problems before they lead to serious complications. This includes monitoring blood pressure, cholesterol levels, and blood sugar, as well as considering factors such as family history and previous diseases that may increase the risks of developing cardiovascular diseases.
Special attention should be given to prevention, which should be adapted to the physiology and life circumstances of women. This includes establishing a healthy lifestyle with balanced nutrition, regular physical exercises, smoking cessation, and stress level control. For women, it is also important to consider phases of the menstrual cycle and menopause, which can affect the cardiovascular system.
Engaging women in active participation in managing their health, informing them about risks and methods of reducing them, can not only improve health but also reduce the overall mortality rate from cardiovascular diseases among women.
