Women at the heart of cardiovascular disease

Cardiovascular disease is the second leading cause of death in Canada. And although they affect more men than women, the latter are more likely to die from them. Three cardiologists shed light on this issue and put forward some possible solutions.

Worrying figures, but little known

“If you ask women what they think is the biggest threat to their health or life, they’ll say breast cancer,” says cardiologist Thais Coutinho, director of the Canadian Women’s Heart Health Centre. “But most don’t know that cardiovascular disease is the number one killer in the world, killing four to five times more women than breast cancer. »

Infarction, heart failure, cerebrovascular accident (or CVA): all these so-called “cardiovascular” diseases concern the heart or blood circulation. Although they strike men more often than women, it is nevertheless “one in three women in Canada who will be affected by one of these diseases during her lifetime”, estimates cardiologist Christine Pacheco Claudio, of the Center hospitalier de the University of Montreal (CHUM).

This can affect women of any age. A 2014 Canadian study notably showed that while these diseases seem to have been on the decline overall for several decades, they are affecting more and more women under the age of 55 and that they are more likely to die from them than men of the same age. .

Why this marked disparity between men and women? Several causes have been identified by cardiologists.

Predispositions, atypical symptoms and complex diagnosis

First of all, cardiovascular disease is said to be multifactorial: two or three risk factors, such as diabetes, tobacco or a genetic predisposition, are sometimes enough to cause the disease. However, women and men are not equal when it comes to these factors. For example, “female smokers are seven times more likely than male smokers to develop cardiovascular disease,” says Dr.^D Christine PachecoClaudio. Women also have unique risk factors related to menopause, birth control pills or pregnancy.

Cardiovascular disease is also expressed differently in women. “Women may feel not pain, but warmth, pressure or heaviness in the chest. They may also have accompanying symptoms: shortness of breath, dizziness, or stomach pain,” explains Dr.^D Christine PachecoClaudio. The risk of contracting cardiovascular disease is often little known to women, who will therefore tend to attribute these symptoms to other causes.

“However, the earlier we intervene, she says, the less sequelae we keep in general, while if we wait a few hours, or even several days before consulting, the damage can be irreversible. »

These atypical symptoms are difficult to identify by women, but also by doctors, because upstream, few women participate in studies on the issue. “Currently, in clinical studies in cardiology, less than 30% of participants are women. So our guides to recommendations for diagnosis and treatment are mainly based on data taken from men,” said Dr.^D Marie-Eve Piche.

The importance of awareness

In summary, “cardiovascular diseases in women are not sufficiently recognized, studied, diagnosed and treated”, concluded an article published in 2020 in the Journal of the American Heart Association including the D^D Thais Coutinho is a co-author.

What can be done to stop this trend? We must both prevent and cure, according to the researcher.

On the one hand, knowing these risks better could indeed enable them to adopt better behaviors in order to avoid contracting the disease. “We can prevent almost 80% of cardiovascular disease through good lifestyle habits: avoid smoking, be active, control weight, have a good diet and good quality sleep, manage stress and anxiety…”, lists the D^D Marie-Eve Piche.

On the other hand, better knowing the signs of a heart attack could lead women to consult more quickly in case of doubt, before it is too late. “If a woman is unwell and it’s something that worries her, she needs to know that she can see a doctor to ask for a checkup, to be sure it’s not a heart problem. “, adds the D^D Christine PachecoClaudio.

A problem not sufficiently recognized

“Cardiovascular health in women should be a priority issue for the population, government and society. Education is needed for this, with women, but also with health professionals. This requires the creation of clinics specializing in women’s health and more investment in research to improve the care provided to patients,” explains Dr.^D Marie-Eve Piche.

According to the D^D Thais Coutinho, these changes must come “from above”. “We are only a few people, or a few institutions, working on this issue, so progress is slow. Things will really change when the government decides to adopt a national strategy to improve the cardiovascular health of women,” she says.