What are the causes of cardiovascular disease in women, and how to protect from it?

Being aware of and knowing how to identify female cardiovascular risk factors is essential for women of all ages. A well-informed woman will be mindful of her risks and will understand that some of them can be magnified in the woman’s body.

To cite some examples, smoking is worse in women under 50 years of age because it increases the risk of a heart attack; Young women tend to have lower levels of cholesterol than men of their age, although from the age of 65, LDL cholesterol (which we commonly call “bad “) will rise more; With menopause, systolic pressure can increase abruptly, and after 75 years of age, hypertension is an essential cause of ventricular hypertrophy, heart failure, and stroke in the female population.

Healthy lifestyle guidelines are crucial to preventing cardiac and cerebrovascular events in both men and women. Risk factors can be modified with lifestyle changes: smoking, hypertension, hypercholesterolemia, obesity, diabetes, a sedentary lifestyle, high alcohol consumption, depression, and inflammatory diseases.

With menopause, the protective effect of estrogen disappears, the risk of obesity and hypertension increases, and lipid levels rise, which is why all scientific cardiology societies recommend embracing healthy habits:

Diet: According to the guidelines spread by the scientific societies involved, the diet should be made up mainly of fruits and vegetables, whole grains, skim dairy, poultry, fish and dried fruits. They limit the consumption of red meat, sugary foods and beverages, and other saturated fats and recommend keeping salt at bay.

Physical Exercise: Although each woman adjusts her exercise pattern according to her age, general health, physical condition and taste for certain sports, to prevent CVD, a minimum of 150 minutes of weekly physical activity is recommended, and 300 minutes for those who need to lose weight. Walking, cycling, swimming and dancing are the most recommended activities for cardiovascular protection, at least half an hour a day.

Control stress and pamper emotional health: They recommend managing stress before it shoots up and damages arteries or worsens other cardiovascular risk factors. Acute stress leads to neglecting diet, smoking, and alcohol, among other harmful habits. Practising mindfulness, yoga or any other activity that reinforces psychological health can be effective.

Update on neglected CVD risks in women

A monograph on women and cardiovascular disease just published in the Journal of the American Heart Association, the official scientific journal of the AHA, confirms that women’s specific CVD risks are neglected. The latest research from five AHA-selected universities points to complicated pregnancy, emotional and physical stress, sleep habits, and many other unique physiological aspects that contribute to increased female cardiovascular risk.

Risk of pregnancy with complications

Complications in pregnancy (not pregnancies that are developing typically) can be used to better assess cardiovascular risk and prevent coronary artery disease (which occurs due to lack of flexibility and narrowing of the arteries, which can cause angina pectoris, myocardial infarction, heart failure or arrhythmias).

One of the studies concludes that since women tend to have more access to medical care during pregnancy and in the postpartum period, an early evaluation of their cardiometabolic health in the first months of pregnancy can help identify risks of pregnancy complications and gestational diabetes and also find opportunities to improve future cardiovascular health.  

Complications include hypertensive disorders of pregnancy, premature delivery, low birth weight, gestational diabetes, and the risk that the pregnant woman will have hypertension 2 to 7 years after delivery.

It has been seen that women with an adverse event in their first pregnancy or gestational diabetes had a high cardiovascular risk profile in the first trimester: more obesity, higher blood pressure, higher glucose concentration, more insulin, high triglyceride level, etc. These parameters, combined with diet quality and physical activity, are associated with a higher risk of hypertension 2 to 7 years after delivery.

Risk of sleeping poorly and snoring

Columbia University researchers have concluded that poor sleep quality and the risk of obstructive sleep apnea affect blood pressure. Women who sleep seven or more hours, with good quality sleep, without insomnia or snoring, with a low risk of apnea, and who feel active and alert in the morning have better overall cardiovascular health, especially in postmenopausal women. 

Poor sleep can negatively impact cardiovascular health if consumed with a more energetic and low-quality diet. And psychosocial risk factors also play a role: depression, little social support and acting as a caregiver for others.

Risk of a sedentary lifestyle

The University of California San Diego (UCSD) focused on understanding risk factors and intervention methods to correct the metabolic consequences of sedentary behaviour according to the time spent sitting by Latina women: an average of 5.6 hours daily. Most of the time is spent in front of the television or computers (3.1 hours/day), only 1.7 hours in leisure activities, such as knitting or chatting with friends, and 1.02 hours in daily transport.

Other studies propose reducing the time spent sitting, associated with specific biomarkers of cardiometabolic risk that would increase cardiovascular risk, with a behaviour modification program. And at the same university, they evaluated the relationship between CVD risks and lifestyles, including the duration of overnight fasting, mindfulness and behavioural and physical risk factors. 

Risk of work and social stress

Long-term data from 80,825 women, with a mean follow-up of 14.7 years, were analysed to conclude that job stress, stressful life events, and social stress are separately associated with an increased risk of coronary heart disease in women. Researchers have found that exposure to social and work stress interacted synergistically, producing a higher risk of coronary heart disease than expected when exposed to each stressor separately. For job stress, the increased risk overlapped with socioeconomic factors.

Myths that women should banish their cardiovascular health

As in other health issues, there are many myths related to CVD. The most frequent ones warned by the GoRed for Women campaign are the following:

  • I’m too young to worry about the heart.
  • If I had high blood pressure, I would notice the symptoms.
  • Cholesterol should not be controlled until a certain age.
  • I will know how to recognise a heart attack because my chest will hurt.
  • If I take the necessary medication, diabetes will not affect my heart.
  • My legs hurt because I’m older.
  • If my heart beats fast, I can have a heart attack.
  • I can’t exercise because I’ve had heart disease.

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