Coronary artery disease in women

Dr Bhawna Singh
Cardiovascular Diseases are one of the major causes of loss of life worldwide. CAD (Coronary Artery Diseases) that is blockages in the arteries of heart, leading to heart attack and stroke are the main culprits.
The incidence of Coronary artery Disease in women is on high rise. The Inter Heart study carried out in 52 countries revealed that women have their first presentation of CAD about 10 years later than men, mostly after menopause. Despite this delay, CAD is increasing more rapidly among women.
Major factors for Heart Attack:
High Cholesterol
Smoking
High Blood Pressure
Diabetes
Abdominal Obesity
Stress
Low intake of fruits
Alcohol consumption
Physical inactivity
These risk factors accounted for occurrence of CAD in 90% of men & 94% of women. There is an epidemic of CAD in India. It has increased from 27.64 million patients in year 2000 to 61.52 million patients by 2015 in reported cases. Loss of life in men is 386 per lac population & in women 283 per lac population, which is twice as that of USA. Heart attacks leading to sudden deaths, before reaching hospital, in women is higher amounting to 52% as compared to men which is 42%.
Reasons for increased susceptibility in Indian women for heart attack:
Women have 15% higher prevalence of high blood pressure than men. Their blood pressure is more under treated and poorly controlled.
Women require higher serum level of HDL (Good Cholesterol), that is 50 mg/dl as compared to men that is 40 mg/dl, to prevent heart attack. After menopause, there is rise in triglycerides & LDL cholesterol (Bad Cholesterol) in serum. There is increased prevalence of obesity among females. Most do not engage in physical activity and 18% of them are smokers.
Depression is 3-4% is more common in women and is a major cause of heart attack.
Stress of modern life and sedentary lifestyle is common in women making them more prone to heart attack. Oral contraceptive users, who are above 35 years of age and smoke, run for fourfold risk of heart attack and stroke.
Prevention of CAD and Heart attack among women:
* Stop smoking and limit alcohol intake.
* Engage in regular exercise for atleast 30 to 40 minutes a day, 5 days a week.
* Maintain healthy diet, low in trans-fats and high in fiber. Take anti-oxidants and nutritional supplements as per age.
* Regular check and control of blood pressure is required. Medicine should be taken regularly if advised.
* Keep a watch on Blood Sugar and maintain good control, once detected with diabetes.
* Obesity is a serious problem & must be addressed accordingly. Do not ignore childhood obesity.
* Get “lipid profile” checked up and control it through diet, exercise and if required, through medicines like Statins.
* Aspirin is a good blood thinner which should be taken regularly by post-menopausal women, if advised by a doctor as it can prevent heart attack
* Regular meditation and yoga keep stress and CAD at bay.
Dietary measures that keep your heart healthy:
* Avoid junk, canned, processed food & red meat as they increase bad cholesterol and uric acid, which are risk factors for CAD. They also contain saturated fats, which are also harmful.
* Trans-fats should be avoided. These are mainly found in commercially baked cookies, cakes, muffins and Pizza dough, packaged snacks like microwave popcorns, chips and candies, fried food like French fries, fried chicken, chicken nuggets. Pre-mixed products like cake mix, pan cakes, chocolate milk also contain trans-fats.
* Consumption of ghee and poor control of sugar can lead to lone rise in triglycerides, the bad cholesterol.
* Good amount of green leafy vegetables, specially spinach has been found to prevent heart attack.
* Sprouts mainly fenugreek seeds are not only rich source of anti-oxidants but also their high fiber content prevents absorption of fat from food and lowers triglycerides.
* Add flax seeds and oats to your diet as they are rich in fiber and Omega 3 fatty acids.
* Garlic helps in lowering bad cholesterol and keeps blood thin.
* Nuts like almonds and walnuts reduce bad cholesterol and fatal arrythmias and raise good cholesterol. Walnuts are rich in Omega 3 fatty acids.
* Omega 3 fatty acids are found in abundance in fish and other sea foods along with Vitamin A and D and are protective for heart.
* Colored fruits and vegetables are rich in anti-oxidants which removes free radicals that are harmful for the arteries.

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