Many people today are enamored with the idea of speed, rapid transformation, thrills, and adventures. Indeed, these are prominent characteristics of our modern society. What we may fail to notice is that this highly charged lifestyle has allowed stress to become our constant companion.
Chronic stress has been recognized as a risk factor for heart disease because it exposes us to high levels of stress hormones, increases blood pressure and heart rate, and may damage artery walls. It’s no wonder, then, that millions of individuals around the world succumb to heart diseases. In fact, heart disease is one the number one cause of death in the world and the leading cause of death in the U.S.
According to the American Heart Association, cardiovascular disease and stroke cause the death of one out of three women each year. That means that approximately one woman dies of these diseases every 80 seconds!
Heart disease in women
According to Women’s Health, there are certain kinds of heart diseases that affect women more than men. They are:
Angina (also called angina pectoris) is chest pain and discomfort that occurs when the heart muscle doesn’t get enough oxygen from the bloodstream. Although men also experience angina, women are more likely to experience two particular types of angina, stable and variant (Prinzmetal):
- Stable angina: Stable angina is characterized by chest pain that occurs during physical activity or stressful situations. It usually diminishes with rest. Stable angina can progress into unstable angina that may be a precursor to a heart attack or sudden cardiac death (cardiac arrest).
- Variant (Prinzmetal’s) angina is a rare type of unstable angina that is caused by a spasm of the coronary arteries. These spasms often culminate in painful attacks, most often during sleep or while resting. The spasms are often triggered by smoking, cocaine use, stress, or exposure to cold weather. This type of angina does not usually lead to a heart attack.
2. Coronary Microvascular Disease (CMD)
CMD occurs when very small coronary blood vessels—those that are too small to see on a coronary angiogram—are diseased, compromising blood supply to the heart’s muscle. CMD usually occurs in women younger than 50. The disease makes them more prone to having a heart attack.
3. Broken heart syndrome
Broken heart syndrome is also known as takotsubo cardiomyopathy, apical ballooning syndrome, or stress cardiomyopathy—the latter name because a specific localized stress-induced cardiomyopathy is thought to be the major reason for this relatively unusual heart condition. Even if one is perfectly healthy, stressful situations such as intense anger, sadness, or shock can trigger the broken heart syndrome in women. It has been widely speculated that actress Debbie Reynolds may have died of broken heart syndrome the day after her daughter, Carrie Fisher unexpectedly passed away.
Vascular health and traumatic events
Although traditional risk factors, such as smoking, diabetes, abnormal lipids, and high blood pressure certainly contribute to cardiovascular diseases in women, Dr. Rebecca Thurston, Professor of Psychiatry at the University of Pittsburgh School of Medicine, recently published a study in the December 2017 issue of the journal Menopause that showed that traumatic events are also a major risk factor for vascular disease in women, thus increasing their chances of heart disease.
Dr. Thurston studied 272 non-smoking women nearing or in menopause, asking them about prior traumatic experiences such as sexual harassment, a child’s demise, being physically assaulted, surviving a car crash or other accident, or living through a natural disaster. She found that women who had experienced three or more traumatic incidents earlier in their lives had poorer endothelial function (the function of the lining of their blood vessels) regardless of their other risk factors for heart disease.
Dr. Thurston commented about this revelation:
“These findings underscore the importance of psychosocial factors, such as trauma exposure, in the development of heart disease risk in midlife women.”
Further, she stresses that,
“When we consider the determinants of women’s cardiovascular health, we need to think beyond biology alone.”
This study is significant because, with the exception of a large body of work on the health impact of adverse childhood experiences, very little research has been done with regard to the impact of other types of traumatic experiences on cardiac health. Dr. Thurston hopes that her study will encourage medical practitioners to inquire about their patients’ history of traumatic experiences and focus special attention on their specific treatment needs.
Joann Pinkerton, the executive director of the North American Menopause Society (NAMS) echoed Thursten’s views when she said,
“Given the large percentage of postmenopausal women affected by heart disease, this is an important study that should remind health care providers of the need to thoroughly discuss a woman’s history beyond simply asking about her physical health.”
Sleep may be a buffer
Needless to say, women need to take charge of their lifestyle and incorporate heart healthy habits into their daily routine. Exercising, eating a balanced and healthy diet, thinking positive thoughts, to name a few, can go a long way in improving the cardiac health among women. For many, it may just be a minor shift in their daily routine. For others, it may require more significant change. Either way, women need to be aware that in addition to modifying traditional cardiovascular risk factors, their past history of traumatic events may play a role in their heart health. Luckily,
“Thurston’s findings also showed that women who got enough sleep were buffered from the harmful vascular effect of trauma, with implications that maximizing sleep health may be particularly important to protecting women’s hearts and blood vessels.”
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The bottom line
When it comes to cardiovascular health, the more we know, the more we can do to optimize our lifestyles to support our heart’s health.
Aditi Gupta Jha, MBBS, MD
Dr. Aditi Gupta Jha has been a practicing physician for over 6 years now, working at the emergency department of hospitals like Fortis and St. Philomena's. She has completed her MD and was awarded a Doctor's degree from Angeles University Foundation, Philippines. She is also the consulting physician & chief editor at JustDoc, a platform that connects patients with top doctors via online consultation.