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Heart disease is not just a men's disease

Shortness of breath and a feeling of constriction – “as if their bra was on too tightly” – are symptoms of heart disease in women. Photo/Getty Images

Heart disease can present differently in women – here’s what to watch for.

Heart disease is often perceived as predominantly a men’s disease, and women underrate their risk, says Auckland cardiologist Fiona Stewart. Although male rates are indeed higher, women tend to see their risk of dying from breast cancer as greater than their chance of dying from a heart attack, when the opposite is true. In 2013, 2200 women died of ischaemic heart disease – more than three times the number who died of breast cancer.

Stewart says the presentation of heart disease can often be quite different in women, and difficulty in recognising symptoms “is a problem in the community and in the medical community as well”.

“It’s the same disease; we have no idea why the presentation is different.”

Read more: What's your risk of a heart attack? | New research helping doctors understand your ever-changing risk of a heart attack or stroke

Common symptoms in women are fatigue, shortness of breath and sleep disturbance, rather than chest pain. Women are more likely to report a feeling of constriction, “as if their bra was on too tightly”.

“Women tend to self-treat and go back to the whanau for reassurance. Time delay [in seeking help] is an enormous issue.”

Women who undergo premature menopause – largely those under 40 – are at higher risk of developing early coronary disease, and those who have high blood pressure prior to menopause also have increased risk. Rates of coronary disease in women increase significantly after menopause, “but there are a worrying number of events in younger women, and these are not always related to smoking and diabetes”.

Stewart says that although “a lot of women do a lot of exercise”, many are so overwhelmed managing their children, job and home that “they always come last and it’s difficult. Tell a woman with a young family to exercise in the morning or evening and she’ll say, ‘Who’s going to get the children to school and cook dinner?’”

Stewart suggests lunchtime walks, perhaps with a group of colleagues to increase motivation.

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