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We tend to be surprised that younger women are having more heart attacks than before, but the trends were discovered in the Atherosclerosis Risk in Communities Study two years ago. Researchers reviewed more than 28,000 hospital admissions for heart attacks in four cities and were surprised to find that while the rate of heart attacks had fallen among the elderly, it had increased in women ages 35 to 54, primarily in their reproductive cycle. . . Traditionally, women’s menstrual period, with active estrogen, was thought to protect them from premature heart attacks. But as cardiologists, we don’t ignore the possibility of early heart attack symptoms, nor do we ignore chest pain or discomfort of any kind among women.
There is clearly an increased prevalence of risk factors associated with current lifestyle behavior among younger women. Crossing the threat threshold is the fact that more women are turning to smokers at an earlier age, which increases their risks.
Smoking: Smoking tobacco is known to sharply reduce high-density lipoprotein (HDL), or good cholesterol. In addition, it causes inflammation, increases blood clotting or thickening of the blood, and damages the lining of the arteries. Reports indicate that smoking has increased the risk of heart disease and stroke by two to four times in both men and women. Also, female smokers have a 25 percent higher risk of heart disease than male smokers. Carbon monoxide and tobacco deprive the heart, brain and arteries of oxygen.
Then there is vaping that has been reported by the American Heart Association as well. Did you know that vaping can increase the risk of heart attacks by 34 percent? There is overwhelming evidence of the negative attributes of electronic nicotine delivery systems (ENDS) to human health. E-cigarettes may be banned but are accessed in secret.
It may not contain tobacco per se but it does contain nicotine, which is a toxic chemical and the main ingredient of tobacco, and its unregulated levels are addictive among users. The flavors are intended to target teens and young adults, who end up having no control over their nicotine intake. Vaping has been shown to increase the risk of subsequent addiction to cigarette smoking. Also, levels of nicotine dependence in young e-cigarette users have been reported to be two times higher compared to traditional tobacco smokers. Nicotine causes endothelial dysfunction, which limits the growth of new blood vessels and fuels inflammation. Daily e-cigarette use was found to be independently associated with an increased risk of heart attack. We cannot ignore drug use among young women either, which increases the risk of heart-related death due to lack of blood flow to the heart or arrhythmias.
High levels of stress: Young women are exposed to higher levels of stress in the workplace than was reported a generation ago. While competitive work schedules mean they accomplish the same as men, we forget that they also take on additional role responsibilities expected from their family role, where they don’t get help or share tasks. Accelerated stress levels stimulate the production of adrenaline and cortisol, which leads to inflammation of the arteries and the formation of atherosclerotic plaques and thrombus or blood clots. It can lead to unstable angina, heart attack, and sudden cardiac arrest. Sometimes smoking is caused by stress in younger women.
Unregulated use of birth control pills: More and more younger women are becoming sexually active early in their cycle and are taking oral hormonal birth control pills to prevent pregnancy, which affects the heart. Studies have shown how the hormones in birth control pills can raise your blood pressure if you have high blood pressure. Most women don’t have their blood pressure checked before they start popping pills. Nor do they rely on medical advice because they buy it without a prescription. Birth control pills are a blood thinner or cause blood to clot. These also alter the composition of blood lipids, reducing HDL and increasing low-density lipoprotein (LDL) and triglycerides.
Risk Factors Related to Traditional Lifestyle Obesity, a sedentary lifestyle, poor diet, and lack of exercise are as common among young women as men. Then there is diabetes, which by itself increases the risk of heart attack two to four times. In general, diabetes is also associated with obesity, high blood pressure, and mixed lipid levels that together greatly increase the risk of heart attacks. According to a recent study, the prevalence of hypertension in Indians below the age of 30 is said to be 11.2 percent. High blood pressure causes the arteries to thicken.
Know and control your risk factors: Monitor your blood pressure, blood sugar, and cholesterol levels regularly. If any of these factors appear to be outside the healthy range, work with your healthcare provider to manage them effectively. Understand your family’s medical history, particularly regarding heart disease, and share this information with your healthcare provider. It can help determine if you have an increased risk and need appropriate preventative measures.
Look for regular check-ups: Visit your healthcare provider for routine check-ups, even if you feel well. Regular check-ups and assessments can identify any underlying health concerns and allow for early intervention if needed.
It’s time to abandon traditional ideas about heart attack as a matter of concern to men. Heart disease is the leading cause of death for both men and women. It is therefore equally important for women of every age to be alert to symptoms, some of which are not so obvious, and to seek immediate medical attention. Leave no room for doubt.
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