Britain’s biggest killer of women is heart disease and now a new test could double the number of diagnoses and lead to fewer deaths and faster treatment. Healthista reports on how to know your risk
Women in the UK are three times more likely to die from coronary heart disease – that’s Britain’s biggest killer of women – than they are of breast cancer and each year, 110,000 men and 65,000 women are diagnosed with a heart attack. But one of the reasons so many less women than men seem to get heart attacks is because the diagnosis is overlooked and often mistaken by doctors for such things as indigestion or even stress.
Now, a new blood test is set to change that. A study funded by the British Heart Foundation (BHF) and published in the British Medical Journal found that a new ‘Abbott’s high sensitive blood test’ could double the numbers of heart attack diagnoses in women and lead to better, quicker treatment and fewer deaths.
Heart attacks in women are often mistaken by doctors for indigestion or even stress
In the study which included 1000 men and women admitted to a Scottish hospital with chest pain, the researchers compared the effectiveness of the new test with routine testing for heart attacks and staggeringly, the number of women diagnosed with heart attacks doubled.
Heart attacks – an old lady thing only?
Think heart attacks are something that happen only to old ladies? Think again. According to Heart UK, nearly 40 per cent of female deaths from heart attack happen before the age of 75.
Indeed, three weeks ago, Jenni Stevens, a 41 year old mum from Edinburgh, collapsed at work with chest pains and rushed to hospital. She was given a high sensitive blood test and doctors diagnosed a heart attack and she received life-saving surgery on the same day.
‘I’d been having chest pains for about a month,’ says Jenni. ‘As a working mum I put it down to stress but last week, as I was walking into work, the pain got much worse and I collapsed, causing my colleagues to call an ambulance.
‘As much as I was frightened, I felt a sense of reassurance when I got to the hospital. They took my blood and did other tests. They thought I’d had a heart attack. I was treated with a stent to save my loire and am so genuinely grateful that my heart attack was spotted and treated so well.’
The National Institute of Clinical Excellence (NICE) has recommended that the new tests be used so expect to see them rolled out in A&E across the country.
So what are the symptoms of a heart attack in women?
- A dull pain, ache or “heavy” feeling in the chest
- A mild discomfort in the chest that makes you feel generally unwell
- Pain that spreads to the back, arm or stomach
- Pain that feels like a bad episode of indigestion
- Chest pain accompanied by feeling light-headed or dizzy
That said, other more subtle symptoms may also occur in women which include feelings of anxiety, shortness of breath, sleep disturbances and fatigue and weakness.
What puts me at risk of heart disease?
If one of your parents suffered a heart attack, you may be at increased risk. According to Ben Kolb, a spokesperson the the BHF, genetics are a big risk factor in heart disease. If one of your parents had it, you may have inherited genes that mean you process cholesterol in ways that increase your risk. That said, you can impact your risk with a healthy lifestyle. ‘You can take lifestyle steps throughout your life to lower your risk significantly,’ Kolb explains (see below for two tips).
Certain ethnic groups such as South Asians and those from an African Caribbean background are at increased risk.
Smokers are twice as likely to have a heart attack as those who have never smoked. Smoking makes blood less likely to clot which increases risk of heart attack or stroke. It also stimulates adrenaline, which raises blood pressure and makes the heart pump harder.
High blood pressure
High blood pressure – or hypertension – means that your blood pressure is consistently higher than the recommended level. High blood pressure is not usually something that you can feel or notice, but over time if it is not treated, your heart may become enlarged making your heart pump less effectively. This can lead to heart failure. Having high blood pressure increases your chance of having a heart attack or stroke. Unless your doctor tells you otherwise, your blood pressure should be below 140/90mmHg.
Cholesterol is a fatty substance found in your blood and if you have too much in your blood, it can increase your risk of heart disease and other cardiovascular diseases.
Cholesterol is carried around the body by proteins and when cholesterol and proteins are combined, they are called lipoproteins. There are two main types of lipoproteins:
Low-density lipoproteins (LDL) is known as the bad type of cholesterol. LDL carry cholesterol from your liver to the cells that need it.
High-density lipoprotein (HDL) is known as the good type of cholesterol. HDL carry cholesterol away from the cells and back to the liver to be broken down.
Too much bad cholesterol (LDL) in your blood can cause fatty material to build up in your artery walls. The risk is particularly high if you have a high level of bad cholesterol and a low level of good cholesterol.
You should aim to have a total cholesterol level under 4mmol/l especially if you are at risk of, or already have, heart and circulatory disease. You should also aim to have your LDL under 2 mmol/l and your HDL above 1 mmol/l.
Being overweight or obese increases your risk of high blood pressure, Type 2 diabetes and high cholesterol – all risk factors for heart disease. One of the best ways to tell whether you need to lose weight from a heart disease risk perspective is by taking your waist measurement.
Fat around your middle can increase your risk of getting heart disease, cancer and type 2 diabetes. That’s because these fat cells produce toxic substances that cause damage to your body.
Measure your waist by finding the bottom of your ribs and the top of your hips, and measure around your middle at a point mid-way between these. For many people this will be at the level of the tummy button.
For women (white European) over 80cm (32”) is an increased risk and over 88cm (35”) is a severe risk.
For women (African-Caribbean, South Asian and some other minority ethnic groups) over 80cm (32”) means you’re under severe risk.
See your doctor who can prescribe a dietitian and exercise programme on the NHS.
Diabetes causes high levels of glucose in your blood. This can affect the walls of your arteries, and make them more likely to develop fatty deposits (atheroma). If this builds up in your coronary arteries (the arteries that supply oxygen-rich blood to your heart) you will develop coronary heart disease, which can cause heart attack and angina. There are two types of diabetes:
Type one diabetes happens when your body cannot make insulin. This type usually affects children and young adults.
Type two diabetes occurs when your body can’t produce enough insulin or the insulin doesn’t work properly. Type two diabetes is more common and tends to develop gradually as people get older – usually after the age of 40.
2 key ways to prevent heart disease
Of course, you know about not smoking (see above) and having all the medical tests you need, but there are key lifestyle measures that can help.
Walk for half an hour a day
Just 30 minutes of brisk walking, five times a week can lower your risk of a heart attack. Conversely, a study in May last year published in the British Journal of Sports Medicine found that women in their 30s who were inactive were a whopping 50 per cent more likely to develop heart disease in their lifetime.
Eat a Mediterranean diet
Countless studies have linked the high olive and olive oil, fish, unprocessed grains, fish and multicoloured fruit and vegetable content of the Mediterranean diet to lowered risk of heart disease. In this one from the New England Journal of Medicine, published in April 2013 found a Mediterranean diet high in olive oils and nuts signicnantly reduced the incidence of heart attack in those at risk.
All Britons over 40 are entitled to a free NHS Healthcheck which includes tests for cholesterol, Type 2 diabetes and blood pressure – talk to your GP. Find out more at the British Heart Foundation’s website
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