NEW DELHI: World Heart Day on 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, said 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.
