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Women and coronary heart disease

Coronary heart disease (CHD), is a common form of cardiovascular disease (CVD).

What is coronary heart disease?1

Coronary heart disease (CHD), also known as coronary artery disease (CAD) or ischemic heart disease, is a common form of cardiovascular disease (CVD).2

Ideally, blood vessels are soft and pliable to allow them to contract and expand as blood passes through. However, in people with CHD, a progressive thickening and hardening of the artery walls occurs (arteries are blood vessels that carry blood away from the heart to all parts of the body). This thickening and hardening (atherosclerosis) is the result of a cascading build up of fat, cholesterol, immune cells, inflammatory cells, blood clot and other substances in the inner lining of the arteries; the build-up is called a plaque (or sometimes a lesion).

If the vessels to the heart get too clogged, the blood supply to the heart is reduced which can lead to symptoms such as angina. Angina is chest pain or discomfort that occurs when a person's heart doesn't get enough blood. This pain can sometimes be experienced in the shoulders, arms, neck, jaw, or back, or may feel like indigestion. Ultimately this may lead to a heart attack.3

Heart disease statistics:

  • Heart disease is the leading cause of death in Australian women. 4
  • Four times more women died from heart disease than breast cancer in 2008. 4
  • Heart disease kills almost as many women as it does men. 4
  • 33.2% of Australian women over 55 years of age are at a high to extreme risk of experiencing a cardiovascular event such as a heart attack or stroke.5
  • On average, approximately 216 Australian women die each week from heart disease.

What are the symptoms of CHD?

The symptoms of CHD may not be the same in women as they are in men. More often than men, women describe multiple symptoms, not just chest pain. Women are significantly more likely to report back pain, jaw pain, neck pain, nausea, and shortness of breath as well as reporting abdominal pain, nausea and fatigue more commonly.6

How do I know if I'm at risk of CHD? 7

There are a variety of risk factors which can lead to the vessels to the heart becoming clogged and narrow. Behavioural risk factors (risk factors that you can reduce yourself by taking preventive action) are responsible for about 80% of cardiovascular disease.8

The main risk factors are raised cholesterol in the blood, raised blood pressure and smoking, others include:

  • Raised cholesterol - people with high cholesterol are at increased risk of CHD because cholesterol deposits can form in the inner lining of the coronary arteries where they bend and divide, causing them to narrow and clog.
  • High blood pressure - having high blood pressure places more stress in the places where arteries bend and divide. This added pressure also speeds up the rate that cholesterol narrows and clogs the walls of the arteries.
  • Older people are at increased risk of CHD. Women experience cardiovascular disease later in life than men, the average age for a man experiencing their first heart attack is 65.8 years old and 70.4 years old for women.6
  • Smoking - Some of the chemicals in cigarettes, including nicotine and carbon monoxide, damage the inner layer of the arteries. This damage can increase the speed at which cholesterol gets into the walls of the arteries and also can cause blood clots which can lead to heart attacks.
  • Diabetics - People with diabetes are at increased risk because diabetics often have high cholesterol and may have raised blood pressure.
  • Obesity and excess weight - People who are overweight or obese often have high cholesterol, raised blood pressure and have blood that is more likely to clot.
  • Post menopausal women are at increased risk. The causes for this are debatable but it is thought this may be related to the beneficial effects of oestrogens in women who are who have not experienced menopause.9
  • Inactive people - People who are inactive still have a higher chance of CHD, even if they do not have other risk factors such as being a smoker or having high blood pressure.
  • Family history - We usually inherit tendencies from our families (not diseases). Tendencies are risk factors such as high blood pressure, high cholesterol, blood glucose levels, clotting tendencies or body build.

How can I reduce my risks of CHD?

Often there are no symptoms of underlying disease in a person's blood vessels, often a stroke or heart attack will be the first warning of underlying disease.8

It is therefore very important to reduce your risks by living a healthier lifestyle10:

  • Maintain a healthy weight
  • Reduce your intake of saturated fats and trans fats - these fats increase blood cholesterol and heart attack rates.11
  • Quit smoking - The risk of heart attack and stroke starts to drop immediately after a person stops using tobacco products and can drop by as much as half after one year.12
  • Be physically active
  • Know your health vitals - check your cholesterol, blood pressure, blood sugar and waist circumference regularly.

There is evidence to suggest that some foods may lower the risk of CHD. Eating a balanced diet that includes plant foods such as wholegrain cereals, legumes, nuts, fruits and vegetables may decrease your risk.

Some examples of foods that may reduce your risk11

Recommended Food
Type
Examples Details
Oily fish Mackerel, sardines, tuna and salmon (Containing omega-3 fatty acids) Omega-3 fatty acids have been shown to improve blood vessel elasticity and thin the blood, making it less likely to clot and block blood flow.
Some vegetable oils Corn, soy and safflower (Containing omega-6 fatty acids)
Or canola oil or vegetable oils (Containing omega-3 fatty acids)
Omega-6 fatty acids and omega-3 fatty acids can help lower cholesterol when used instead of saturated fats such as butter.
Fruit and vegetables   Fruit and vegetables contain antioxidants that offer protection against heart disease and also provide the body with folate which held lower the levels of the amino acid homocysteine, which appears to be linked to increased risk of heart disease.
Wholegrain cereals   Fibre contained in wholegrain cereals can protect against heart disease.
Unrefined carbohydrate sources with a low glycaemic index (GI) Wholegrain breads and breakfast cereals, legumes, certain types of rice and pasta Help to keep the blood glucose levels in check. This is particularly relevant to people with type 2 diabetes who may have chronically elevated blood glucose levels. Uncontrolled diabetes can damage the artery walls and contribute to CHD.
Legumes and soy   Soy protein has been shown to lower cholesterol levels.
Nuts and seeds Small amounts of unsalted nuts and seeds These should be eaten in small quantities as they are high in kilojoules.
Tea   Some evidence suggests that the antioxidants in tea can help prevent the build up of fatty deposits in the arteries.
Garlic   A compound in garlic called allicin has been found in some studies to lower blood cholesterol

Further information

Sources

  1. 'Women and heart disease: cardiovascular profile of women in Australia.' Cardiovascular disease series no. 33. AIHW 2010
  2. 'Coronary Heart Disease in Australia', AIHW
  3. 'Angina', Health Institute, June 2009.
  4. 'Causes of Death, Australia, 2008', ABS, March 2010
  5. 'Generation Risk - An analysis of cardiovascular disease among Australia's older population', Access Economics, May 2010.
  6. 'Current Clinical Practice: Women's Health in Clinical Practice', 2008
  7. 'Heart Disease - risk factors explained', Better Health Channel.
  8. 'Cardiovascular diseases (CVDs)', WHO, Sept 2009.
  9. 'Women and heart disease', Basic res. Cardiol 93: Suppl. 2,79-84 (1998)
  10. 'Know the facts, not the myths', National Heart Foundation, April 2010.
  11. 'Heart Disease and Food', Better Health Channel.
  12. 'What can I do to avoid a heart attack or stroke?', WHO, Sept 2009.
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Last published: 4 June 2010

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This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

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