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Women and heart disease

by Dr Wynnie Chan
Dr Wynnie Chan explains why it’s not only men who should worry about CHD

Traditionally, coronary heart disease (CHD) has been viewed as a male disease. For years health professionals have focused their attention on men as primary targets for prevention.

But, after cancer, CHD is the second major cause of death among women in the UK. According to a Health Survey For England, it kills at least 76,000 women in this country each year and it’s the biggest cause of premature death in women under 65.

Problems begin when the blood vessels to the heart narrow (due to the accumulation of cholesterol and small blood clots deposited on the blood vessel walls) reducing blood flow to the heart.

Initially, this causes chest pain – called angina – after physical exertion. Eventually one of the blood vessels may become totally blocked and stop blood supply to part of the heart. This leads to muscle damage due to lack of oxygen, which can lead to a heart attack. If the damage is extensive, the heart may beat irregularly or stop altogether, which can be fatal.

On average, women tend to develop CHD ten years later than men. It’s thought that pre-menopausal women are less at risk because:

  • They tolerate high blood cholesterol levels better than men. The ratio of ‘bad’ low-density lipoprotein cholesterol (LDL) to ‘good’ high-density lipoprotein cholesterol (HDL) is higher in pre-menopausal women because oestrogens (female sex hormones) raise levels of ‘protective’ cholesterol and reduce the ‘bad’ levels.

  • They tend to have a more healthy diet. Dietary surveys show that women eat more fruit and veg than men and therefore have a higher intake of antioxidants. Antioxidants, such as vitamins A, C and E, are also found in vegetable oils, nuts and seeds and can help destroy peroxides, the chemicals formed when free radicals (by-products produced by the breakdown of foods or environmental pollutants) combine with LDL cholesterol. Peroxides play a part in the development of ‘plaques’ or deposits that build up on the artery walls and may increase risk of heart disease.

  • They have low iron stores. Pre-menopausal women tend to have low iron stores because of menstrual losses, which is beneficial because excess iron may lead to further damage by free radicals.

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