Every eight minutes a woman dies in Spain from cardiovascular disease and the number of deaths exceeds that of men. On International Women’s Day, cardiologists warn: “Cardiovascular diseases are not men’s business”.
A total of 63,291 women died in Spain in 2021 due to some cardiovascular disease. According to the latest data from National Institute of Statistics (INE), 262.2 per 100,000 women died in 2021, in front of 241.1 men.
In this way, the Spanish Society of Cardiology (SEC) and the Spanish Heart Foundation (FEC) focus on these data to show the prevalence of cardiovascular disease in women and find out which factors increase the risk of occurrence.
Cardiovascular disease in women: prevalence
The INE data show that women die more from cardiovascular diseases than from tumors, while men die more from cancer.
the ischemic heart diseases are located as the most important cause of cardiovascular death in women worldwide, although their numbers continue to be underestimated.
And it is that, although the classic myocardial infarction is three times more common in men than in elderly women, the number of women under the age of 65 suffering from myocardial infarction has increased.
Especially the MINOCA (a type of heart attack without obstruction of the coronary arteries) and the spontaneous coronary dissection (spontaneous separation of the layers of the arterial wall due to rupture or tear of unknown cause), which is estimated as the cause of 30% of myocardial infarctions in these women.
Cardiovascular risk in women at different stages of life
From the SEC point to blood pressure, food, cholesterol, smoking, obesity and sedentary lifestyle as classic risk factors.
However, the hormonal changes that women experience throughout their lives can also affect their risk of cardiovascular disease:
- Women with premature ovarian failure (loss of ovarian function before the age of forty): have a lower life expectancy than those with a late menopause, due to cardiovascular diseases and osteoporosis. Each year of early menopause is associated with an increase in 3% of cardiovascular risk.
- Repeat abortions: having two or more abortions, consecutive or not, can increase the risk of ischemic heart disease.
- premature birth (one that occurs before the 37th week of gestation): Women with this history could have twice the risk of cardiovascular disease in old age.
- Gestational hypertension: affects between the 5 and the 10% of pregnant women worldwide. The preeclampsia (syndrome characterized by increased blood pressure, the presence of proteins in the urine and a malfunction of the endothelium) increases the risk of heart failure and hypertension by four and the risk of ischemic heart disease by two , cerebrovascular accidents and cardiovascular deaths.
- gestational diabetes: occurs in approximately the 7% of pregnancies and is associated with a double risk of future cardiovascular events.
- Combined oral contraceptive pills: they lead to an increase in the risk of venous thrombosis, heart attack and stroke; which increases significantly if the woman smokes.
During menopause, estrogen levels decrease
This decrease in estrogen levels is related to alterations in vascular function.
Likewise, all the hormonal changes that occur are associated with imbalances in body composition with an increase in abdominal fat and changes in the lipid profile, according to the SEC.
In this way, the LDL cholesterol levels (bad cholesterol) i triglycerides they increase by one 10 and one 15%while they go down slightly HDL cholesterol levels (good cholesterol).
In addition, between the 30 and the 50% of women develops hypertension before the age of 60.
How to reduce cardiovascular risk?
“Hormonal influence has a considerable impact on women’s cardiovascular health. The primary prevention of cardiovascular risk factors in women is essential to reduce cardiovascular mortality and improve their quality of life”, explain the doctors Antonia Sambola and Milagros Pedreira, coordinators of the Women’s Working Group in Cardiology of the SEC.
In this same line, they point out as essential the cardiovascular review during pregnancy, postpartum and menopause when the woman involved presents any risk factor.
Some of the strategies that the SEC and the FEC indicate to reduce the risk of cardiovascular disease in women are:
- During the fertile stage: self-monitoring of blood pressure in women after suffering gestational hypertension; monitoring by glucose tolerance tests in women with gestational diabetes; keep a history of pregnancies and follow a treatment according to these cases.
- When the menopause: follow a healthy lifestyle, regularly monitor blood sugar levels, lipids and blood pressure. Avoid hormone therapy in women with high cardiovascular risk.
“In recent decades, the incidence of myocardial infarction in young women has increased, in relation to greater consumption of tobacco and greater incidence of obesity. Prevention is essential to reduce the risk of heart attack in this subgroup of women”, conclude the two specialists.