Women and heart disease

Nearly 60 Kiwi women die from heart disease every week, making it New Zealand's single biggest killer. We look at women's risks of heart disease and what things can impact on heart disease.

Heart disease is the leading cause of death in Kiwi women but many people are unaware of this statistic because they believe it to be a 'man's disease'.

Latest Ministry of Health figures show that more than 3,000 New Zealand women die each year as a result of heart disease and there are currently more than 65,000 living with it.

In the female population, heart disease still tends to be under-treated and overlooked.

When should women get a heart check?

Women without known risk factors:

  • From 55 years of age

Women with significant known heart disease risk factors:

  • From 45 years of age

Māori, Pacific or South Asian women:

  • From 40 years of age

Women with type 2 diabetes:

  • As part of the annual diabetic review

Women with severe mental illness:

  • From 25 years of age.

What puts women at risk of heart disease?

Women and men share largely the same risk factors for heart disease. Smoking, being overweight or obese, high blood pressure and diabetes, as well as a family history of heart problems all contribute to an increased risk of heart attack.

However in many cases women are more vulnerable to these risk factors than men. This is because:

  • Nicotine is metabolised faster, so smoking creates a bigger risk for women
  • Women with diabetes are at a greater risk of heart disease than men with diabetes
  • A family history of heart disease can be a stronger predictor in women

Despite sharing similar risk factors, heart disease tends to occur at a later age for women. This is because the risk for women increases significantly once they reach menopause.

Risk factors which are specific to women:

  • Women who have gestational diabetes or pre-eclampisa during pregnancy have a higher risk of heart disease in later life
  • Some studies have revealed that women who suffer hormonal dysfunctions such as polycystic ovary syndrome before menopause, are at increase risk of heart disease in later life

Common types of heart disease in women:

  • Microvascular angina (also known as cardiac syndrome X)
  • Coronary microvascular disease (also known as small vessel disease)
  • Spontaneous coronary artery dissection (SCAD)
  • Coronary artery spasm (sometimes called ‘prinzmetal angina')

Menopause and heart disease

Menopause is a natural event that occurs when the ovaries stop producing eggs and oestrogen and progesterone (the two main hormones related the reproductive cycle). A woman is said to be in menopause once her period (or menstrual cycle) has stopped for more than 12 months. The average age that most women go through menopause is 52.

Menopause affects a woman's body in a number of ways.

It increases:

  • Low density lipids (‘bad’ cholesterol), which raises overall cholesterol blood levels
  • Blood pressure
  • Body fat
  • Insulin resistance – which can prevent the body from breaking down sugars and thereby increasing the risk of developing diabetes

It can change:

  • Metabolism (the process by which your body converts food and drink into energy). A decrease in metabolism can create a number of problems, e.g raised blood pressure, cholesterol and increased weight
  • Body fat distribution. Fat deposits that sit around the torso as opposed to the hips (sometimes described as an 'apple' body shape) increases the risk of heart disease, even in women of a normal weight.

Hormone Replacement Therapy (HRT) may offer some protection against heart disease and stroke in the first 10 years of menopause.

For most women, it is relatively safe to be on an oral contraceptive. However, it does slightly increase your risk for heart disease, heart attack, blood clots and stroke. For women who smoke, or older women, this risk increases. Your doctor should discuss these risks with you before you are prescribed the contraceptive pill.

How does pregnancy affect your heart?

Your heart has to work much harder than usual during pregnancy as it has a much greater volume of blood to pump around your body. In most women the blood volume will increase by 30 - 50%.

Can I get pregnant if I have heart disease or a heart condition?

If you already have heart disease or a diagnosed heart condition, always check with your doctor first before trying to get pregnant. There are a number of risks you may need to consider depending on your condition and your medication.

Gestational diabetes and heart disease

Gestational diabetes is a type of diabetes which occurs during pregnancy. Often there are no signs or symptoms but you will be screened for it during your pregnancy.

Having gestational diabetes means you are at higher risk of type 2 diabetes in later life, which in turn increases your risk of heart attack or stroke.

Pre-eclampsia and heart disease

Pre-eclampsia is a serious condition affecting about 5% of pregnant women, identified by symptoms like spikes in blood pressure, protein in the urine, severe swelling of legs and hands and headaches or vision problems.

Although pre-eclampsia goes away after pregnancy, it does mean that you're at increased risk of heart disease. In fact, evidence suggests that pregnant women who develop pre-eclampsia have more than double the risk of having a heart attack or stroke later in life.

At least two Kiwi women die from a heart attack everyday. Learn the warning signs that are specific to women.

Heart attacks in women