Women and Heart Disease: Answers from the Experts

What do we know about women and heart disease?
LP: The most striking fact to come out of recent research is that women are more likely than men to die of heart disease. The common misconception that women don’t have heart attacks is a thing of the past: we’re even seeing women develop heart disease earlier in life.
SD: As women age, they catch up to the men very quickly and we see a higher incidence of heart attacks. A woman in her 80s is just as likely as a man of the same age to have a heart attack.

What are the different signs, symptoms, and treatments?
SD: A woman having a heart attack will have the same symptoms as a man: chest pain, shoulder pain, or pain in the jaw. The difference comes in symptoms experienced prior to a heart attack. While chest pains during exercise are a common warning sign for men, women at risk often won’t feel any discomfort when exercising. Similarly, headache, indigestion, or fatigue can precede an event but a woman may feel that such discomforts are unimportant and will ignore the symptoms, thinking they’re indigestion. We don’t mean to say that any ache or pain is automatically a symptom of a heart attack: if the discomfort is out of the ordinary and cannot be explained, that’s when you should seek treatment.
LP: Targeted treatments are still being developed for women. That’s one of the things we’re working towards here at the MUHC. Current treatments have proven successful for men but we can’t assume that women will respond to medication in the same way. In the past, the vast majority of clinical trials have focused almost exclusively on men. We’re trying to level the playing field.

What can women do to protect themselves?
SD: The classic advice is the best advice: don’t smoke and maintain a healthy diet. These are the best things you can do to protect yourself from heart disease. Genetically, some people may be more prone to developing heart disease but the same advice holds across the board. If you eat a healthy diet and avoid cigarettes, your chances of developing heart disease are greatly reduced.
LP: Women should also keep in mind that, while they are at risk of heart disease, they are also a big part of the solution. We’re seeing a rise in childhood obesity at the moment but, for the most part, mothers are responsible for what their kids eat. It’s important to make healthy living a family affair. As a mother of 5 children—four of whom are girls—I definitely have to practice what I preach to ensure a healthy future for them.

How is the MUHC setting the standard for women’s healthcare when it comes to heart disease?
LD: We have some of the best people in the country working here, and Stella is one of them. Her expertise in vascular biology is a great addition to the MUHC’s Division of Internal Medicine as well as to a unique project called GENESIS, which is funded in part by the Heart and Stroke Foundation. As Principal Investigator, I’m leading the GENESIS team in a Canada-wide study of the behavioural, environmental, biological, and genetic determinants for the development, presentation, process of care and outcome of cardiovascular disease. It’s an exciting project and we’re just at the beginning.
SD: I’m very happy to have been recruited to the MUHC. We’ve just begun to set up my laboratory where I’ll be conducting some of the clinical work for GENESIS, seeing women who have or are at risk of having heart disease and working directly with them to define symptoms and develop treatments. It’s an exciting time here: there’s a lot of hope. Really, what it all boils down to is this: we want to answer the question of why women develop heart disease and why they are more likely than men to die from it. We’re focused on women and we’re focused on answers.

For more information on the GENESIS project, visit www.genesisteam.ca