Heart Health

What of a woman’s heart?. A woman’s heart has for long been the… | by SPAG | SPAG Dialogue | Sep, 2021


A woman’s heart has for long been the spotlight of all kinds of art & poetry there is. This, however dims significantly when we lend it a scientific gaze. Women have largely not been the focus of heart health research and development. Sadly so, over the last two decades, sedentary lifestyles, stress and bad dietary practices, high blood pressure, low HDL, smoking and consumption of oral contraceptives have contributed to a rise in heart disease in women at an early age. The issue, however is far more complex than it seems.

A common myth is that women have less heart disease as compared to men but in reality more than 1/3rd of women die of cardiovascular disease around the globe every year. In fact the risk of heart disease in both women and men is grave, but it affects both very differently. The fore said myth is the main reason for the scientific community ignoring problems related to women heart health resulting in inadequate research data available on the issue.

Did you know that there are some stark physiological differences between men and women hearts? For Instance:

  • A woman’s heart is usually smaller and the walls of heart chambers are thinner?
  • A woman’s heart pumps blood faster than a man’s but ejects about 10% less blood with each squeeze.
  • When a man is stressed, the arteries of his heart constrict, raising his blood pressure while a woman’s pulse rate rises, and her heart ejects more blood.

The symptoms a woman experiences and expresses while having a heart attack usually are quite different from men. They complain less of chest pain and more of vague symptoms like ghabrahat (uneasiness), fatigue, weakness etc. These factors lead to nearly seven times higher chances of missing diagnosis of heart attacks in women as compared to men.

This leads to two different observations of CVD in both sexes. Experts often state different reasons based upon significant distinction in biology and physiology of both men and women, like cholesterol blockages, deposits in small arteries, lifestyles, stress coping mechanisms and symptom experiences. Despite having a lower mortality rate than men (1:1.2), reports have suggested that women are more at risk of deaths once they have contracted CVD even with best treatments. However, unfortunately lack of research in this area has never brought down this ‘heart-to-heart’ to a neat conclusion. For instance, cholesterol deposition in the arteries of a male heart occurs more on the surface of large arteries, while in women it occurs in smaller vessels. This creates a false indication of a heart attack.

Comparatively, bypass surgeries are easier performed in major arteries. Moreover, the presence of higher levels of oxytocin in women enables them to be better at coping stress hormones such as cortisol and epinephrine which together shoot up blood pressure and sugar levels. Even the experience of symptoms is different. Men typically get the classic pattern of angina with pain in the left side of chest, while women experience discomfort in the shoulders, back and neck.

The pandemic has compelled global economies to spend more on research of emerging diseases and control. However, the Indian government has significantly cut down its budgetary allocation to health research in the 2021 union budget. The Finance Minister allocated Rs 2,663 crores to the Department of Health Research for the upcoming fiscal year. This is 34.4 % lower than the previous fiscal year. Due to less research and regular budgetary cuts in health R&D, there are a lot of unending loops to such studies. Lifestyle changes in the past decade have created a dramatic increase in cardiovascular diseases, but we do not have a substantial research to create awareness and propagate appropriate behaviour. It’s time that we give as much science to heart, as art.

To this end, there is also an overwhelming need to address the issue of equal representation. In the current setup, patriarchal structures continue to dominate the sector. Be it representation of women in the workforce or their accountability in numbers, India and globally, women study medicine more than men, but practice less. This is a classic case of failed representation. The medical community must step up and acknowledge this study-to-practice gap and specified diagnosis and treatment to ensure equality.

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