The Low-Down On The Risks Of Coronary Heart Disease In Women
By Ng Peng Hock
Coronary heart disease (CHD) is the leading cause of death and morbidity among women in the world, accounting for one-third of all deaths in women worldwide. It is estimated that 1 in 2 women will eventually die of heart disease or stroke as compared to 1 in 25 women who will eventually die of breast cancer. Although men have a higher overall heart attack incidence rate than women did, the chance that women die during heart attack is higher.
The risk factors for CHD are more or less similar for both men and women except for some minor differences. These risk factors include smoking, cholesterol, diabetes mellitus, high blood pressure, physical inactivity, obesity, and last but not least, stress. The management of these risk factors has generally been either ignored or pursued less vigorously in women than men.
Smoking increases the risk of CHD tremendously if there is concomitant use of oral contraceptives.
Raised levels of total cholesterol and LDL cholesterol are weakly associated with CHD in women. Instead, HDL cholesterol is closely and inversely associated with CHD. Triglycerides, especially in older women or diabetics, are independent predictor of CHD.
Diabetes is an exceptionally bad and powerful risk of CHD in women by threefold to sevenfold, as compared to an increase of twofold to threefold in men. Diabetes dramatically increases the death rate of heart attack in women as well.
The importance of high blood pressure is similar in both men and women. Optimal high blood pressure treatment can reduce the various complications such as death, stroke, heart failure or CHD.
A sedentary life style is detrimental to heart health. Regular exercise can offer benefits for women in lowering the risk of CHD.
Obesity is closely related to diabetes and high blood pressure. Central obesity, a waist-to-hip ratio of more than 0.85, is especially associated with CHD in women.
Both acute and chronic forms of stress may play a contributory role in the development of CHD or plaque rupture. In addition, depression, higher level of anxiety and a lack of social support may contribute partly to the poorer outcome in women after cardiac events or cardiac surgery.
One of the best times women should monitor their risk factors is during their pregnancy. They should stop smoking and avoid excessive weight gain. They should seek medical advice on nutrition, physical activity and stress management for heart health benefits.
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