New Delhi: World Heart Day Sunday brings bad news for Indian women who have been found to be more vulnerable to coronary diseases because their arteries are narrower than those of men.
“Since arteries in women are narrower in India, risk factors have a bigger impact. Coronary and heart diseases need to be more aggressively managed in women than men,” Madhukar Shahi, senior interventional cardiologist of Gurgaon-based Artemis Health Institute, told IANS on World Heart Day.
The mortality rate among women suffering from cardiovascular diseases is also higher than that of men across the world, including India, because of lifestyle changes in metropolitan cities where women work graveyard (late) shifts and are given to smoking and drinking to battle peer and professional pressure.
The theme for this year's World Heart Day supported by the World Heart Federation internationally is 'Know Your Risk', which encourages people to adopt healthy lifestyles and go for periodic health checks.
Olympic marathon gold medal winner Stefano Baldini is supporting the World Heart Day at the global level this year to drive home the message. The World Heart Federation's prescription is simple: “Be active. Thirty minutes of brisk activity and five servings of vegetables and fruits every day can keep the doctor away.”
According to Shahi, negative lifestyles associated with depression, smoking, alcoholism, lack of exercise, poor diet and lack of social support increase the risk of heart disease and interfere with treatment.
“The primary factor that causes cardiac problems is stress. The modern Indian woman is subjected to excessive stress at home and at work. Overworking, under-resting and a higher level of frustration at work bring about greater aggression and take a toll on the quality of life,” Samir Parikh, a leading psychologist at Max Healthcare and a health columnist, told IANS.
“We need to pay importance to our mental health in order to understand its impact on physical health. No matter how much you rush, it is difficult to catch up. The best is to pace oneself to avoid pressure on the heart,” he added.
As smoking is common among the new generation of younger Indian women, pre-menopausal smokers are thrice at risk of heart diseases than men.
“Many women use cigarette as an aid to control their weight because being thin is fashionable. But smoking reduces the HDL cholesterol which increases the risk of heart diseases,” Shahi said.
He also advised younger women using oral contraceptive in India to refrain from smoking.
A study conducted by the New England Journal of Medicine in India in May 2008 of 33,000 deceased women who had smoked showed most of them died or suffered from heart and lung-related respiratory, vascular or neo-plastic diseases. Smoking was associated with reduction in median survival of eight years for women, compared to six years for men in the country.
The study also cited that the prevalence of smoking among women between 30 and 69 years in India rose fairly steadily from three percent to six percent over the decades.
The heart expert said the number of coronary diseases in women had increased by 300 percent in the last five years.
“What makes treatment difficult for women is that surgical interventions like stenting to clear blockages in arteries is more complex as they have narrower arteries,” he said. Awareness about heart disorders among Indian women was also low.
Some of the major causes of coronary diseases among Indian women are diabetes, high cholesterol level or dyslipidemia, smoking, bad metabolism and premature menopause or estrogen deficiency, the doctor said.
A survey conducted by Ravi Kasliwal, senior consultant of cardiology at Apollo Hospitals, and his team showed that 44.1 percent women executives in the mean age of 40 in corporate offices across India showed the prevalence of metabolic syndrome, which contributed to heart diseases.
Heart problems, said Shahi, are predominantly a lifestyle disease.
“Indians are genetically more susceptible to heart diseases because of the changing lifestyles in the metros. Rapid economic development, along with urbanisation, and its attendant major lifestyle changes are contributing more to heart diseases,” he said.
“Graveyard or late night shifts affect women because long hours at work disturb the circadian variation in hormone levels among women,” Shahi said. It leads to heart disorders.
The doctor also said the safe limit for alcohol among women was half that of men.
As precautions, Shahi said Indian women, irrespective of whether they were working or not, should test themselves for blood sugar, lipid profiles, pressure, bio-index mass and weight and avail counselling sessions for exercise and smoking at regular intervals.
“But the formal cardiovascular risk assessment should start at 40,” he said.