When we think of heart attacks and cardiovascular disease (CVD) our immediate assumption is that it’s a male problem but the truth is that it’s the world’s leading cause of premature death and the number one killer of women.
Perceptions need to change
Latest statistics indicate that, around the world, more than two million women die every year due to CVD (including both heart disease and stroke).
The Heart and Stroke Foundation SA says that one in four women will have some form of heart condition before the age of 60 and that once they reach menopause the risk of heart disease increases threefold.
“It’s time for us to change the perception around heart disease,” says Dr Bobby Ramasia, Principal Officer of Bonitas Medical Fund. “The majority of CVDs are preventable so we need to make everyone, but especially women, more aware of the risks, the symptoms and how to take care of their heart.”
One of the main reasons women are less aware of heart disease is that it usually affects them about 10 years later than men and also presents differently. Typical heart attack symptoms in women tend not to be the classic tightness, discomfort or chest pain, instead there are a wide range of sensations which could include an uneasy feeling in the chest, abdominal pain, a fluttering heartbeat, shortness of breath, fatigue, nausea, dizziness and swollen feet.
Because the symptoms differ, they can be easily missed or put down to another illness, plus women often wait longer to go to hospital when having a heart attack – which means they are at a higher risk of dying, or being disabled, as a result of a heart attack than men.
Last year during Heart Awareness Month, the Heart and Stroke Foundation compared heart disease to our crime statistics and noted that while 49 people were murdered in South Africa every day between 2014 and 2015, a whopping 210 people died from heart disease daily … with women a large percentage of that number.
CVD is known as a non-communicable disease (NCD) and the World Health Organisation estimates the burden of NCDs in South Africa to be two to three times higher than in developed countries, accounting for up to 43% of total adult deaths. Of these NCD deaths, a fifth are CVDs. Locally the proportion of deaths in women aged between 35–59 years is one and a half times more likely than that of women in the US. Globally 80% of CVD deaths occur in low- to middle-income countries.
The Minister of Health, Dr Aaron Motsoaledi, says that NCDs are the leading cause of death globally, and the number of deaths is higher than all other causes combined, most of which occur in low and middle income countries. The National Policy on Chronic NCD Prevention addresses diabetes, cardiovascular disease, hypertension and chronic respiratory disease.
Strategies for the reduction of the major risk factors – smoking, alcohol, obesity, unhealthy diet and sedentary lifestyles – are implemented through the existing health network, with the support of both government and non-government organisations in the country.
The 5th World Congress of Cardiology and Cardiovascular Heath held recently in Mexico, attended by health professionals, policy experts and scientists from around the world, was aimed at addressing the CVD epidemic, especially in women. During the Congress, a global declaration on heart health was signed as a unified commitment to address CVDs.
Urgent action required
Called “The Mexico Declaration for Circulatory Health”, it commits to improving circulatory health and reducing deaths and disability from heart disease and stroke around the world. These diseases presently represent the biggest health burden world-wide, accounting for over 17 million deaths every year.
The Mexico Declaration recognises that unless health professionals, business and the public take urgent action, the number of premature deaths will keep increasing. It also calls on NGOs to improve national education and training programmes to help improve diagnoses and treatment. The aim is towards a 25×25 goal: a 25% reduction in premature CVD morbidity and mortality by 2025.
“The tragedy is that the majority of CVD’s are preventable,” says Dr Ramasia. “Preventing and managing CVDs is vital and this means as well as educating health professionals on what to look out for and treatment, we also need women to realise the severity of heart disease and that it is one of their biggest health threats. Now is the time to take action.”
How? Lack of exercise, a poor diet and unhealthy habits all contribute towards ill health. But you’re never too young – or old – to take care of your heart. Here’s how:
- Get active. For a healthy heart, aim for at least 2 ½ hours of moderate physical activity each week.
- Control cholesterol. We all have cholesterol and there are two types: the good kind (HLD) and the bad kind (LDL). High levels of bad cholesterol can clog your arteries, increasing your risk of heart attack and stroke. This is where good cholesterol comes into play: HDL cleans out that bad cholesterol from the arteries
- Eat better. Eating the right foods can help you control your weight, blood pressure, blood sugar and cholesterol. Follow a balanced diet that includes fruits, vegetables, whole grains and other healthy choices
- Manage blood pressure by managing your stress. Keeping your blood pressure in a healthy range starts with eating a heart-healthy diet. Other important factors are exercising regularly, maintaining a healthy weight, limiting salt and alcohol, and reducing your stress levels.
- Maintain a healthy weight. Overweight and obesity are risk factors for cardiovascular disease. 31.3% of adults in SA are obese. Higher body mass index (BMI) is associated with higher risk of type 2 diabetes.
- Reduce blood sugar. Diabetes is a risk factor. Heart disease death rates among adults with diabetes are 2 to 4 times higher. You can minimise the impact of diabetes on your body – and even prevent or delay its onset – by eating correctly, controlling your weight, exercising and taking the medication prescribed by your doctor.
- Stop smoking. It’s time to kick the habit. Going smoke-free can help reduce risk of heart disease and stroke as well as cancer and chronic lung disease.
- Know your family history. A relative, especially a parent or sibling, with heart disease increases your risk of CVD.
- Learn the warning signs of a heart attack and stroke.
Some of the CVD related risk factors in adults in SA are:
- 18% of the population smoke tobacco.
- 1 in 3 SA adults (33.7%) has hypertension, which can increase risk of heart attack, heart failure, kidney disease or stroke.
- 31.3% adults in South Africa are obese.
- 40% of women in South Africa are obese.
- 1 in 4 girls and 1 in 5 boys between the ages of 2–14 years are overweight
- According to data from the World Health Organisation, South Africa has the highest alcohol consumption rate in Africa and one of the highest in the world. In 2014, alcohol consumption (as measured in pure alcohol volumes) increased to 11 litres of pure alcohol consumed per capita. The global average is 6.2 litres of pure alcohol per year.