Heart disease is often thought of as a disease that only affects men, and women often think that it is unlikely to affect them. In fact, heart disease is the number one killer of women in the UK, with around 70,000 deaths each year (about the same number as men). Approximately one in six deaths in women is caused by heart disease. Statistically, heart disease kills four times as many women as breast cancer does. Women of any age can develop heart disease, but for those approaching the menopause, it is even more important to take care of the heart.
In the UK, the rate of heart disease is beginning to fall slightly, but the fall for women is slower than for men. The reason for this is probably because women are taking on habits and roles that are traditionally thought of as those of men, such as smoking, drinking heavily and having stressful jobs.
It is true that female hormones protect women from heart disease during their twenties and thirties. However, within 10 years of the menopause, the rate of heart disease in women is similar to that in men. As women tend to live longer than men, there are more elderly women than men living with heart disease.
Can hormone replacement therapy prevent heart disease?
Hormone replacement therapy (HRT) is given to women past the menopause to increase their oestrogen levels in an attempt to reduce the risk of heart disease. Taking HRT is also thought to lower cholesterol levels. However, the evidence for HRT protecting women against heart disease is quite controversial and research has shown conflicting results. HRT is no longer recommended to prevent heart disease. The effects HRT has on heart disease are not fully understood, and while there are other health benefits from taking HRT, such as a reduction in hot flushes and reduced risk of developing osteoporosis, women need to get medical advice to help them decide what is right for them. It is possible that HRT increases blood pressure, which is a risk factor for heart disease. It may also increase the risk of a deep vein thrombosis. HRT may only delay the problem of heart disease, whereas other measures such as exercise and stopping smoking can prevent it. GPs do not prescribe HRT just to protect women from heart disease.
The symptoms of heart disease tend to appear at a later age in women than in men. The symptoms of heart disease can be different in women than they are in men. Studies have shown that women often notice unusual symptoms in the days before a heart attack. Symptoms are often more subtle than those reported by men and include fatigue, anxiety, palpitations and disturbed sleep. Other women have reported weakness, shortness of breath, dizziness and a cold sweat during a heart attack. Women who experience chest pain describe it as ' sharp', which differs from words like 'crushing', ‘heaviness' or ‘tightness' that are often used to describe chest pain. Doctors and women often mistake the symptoms of heart disease for anxiety, indigestion, fatigue or asthma. This can delay diagnosis. Women are often older when they first experience symptoms, and they may have other conditions, such as arthritis, which can confuse the picture.
The way heart disease is diagnosed and treated is the same for men and women.
Women have been shown not to do as well as men after a heart attack. This is probably because they get help at a later stage and their symptoms are less typical of heart disease, leading to difficulty in diagnosing the condition.
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