Heart disease is the biggest killer of women: What you need to know

Most women don’t realise they will have different risk factors for heart disease than men. Photo / Getty Images
Heart disease is generally seen as a ‘male issue’, but cardiac issues are the leading cause of death for all people in New Zealand, including women.
Statistics from The Heart Foundation put it at more than 55 women a week – or around 3,000 a year – are dying of heart disease, while over 65,000 women are believed to be living with some form of it.
Broadcaster and co-host of the Herald’s The Little Things podcast, Francesca Rudkin, has first-hand knowledge of this, having learnt in recent years that she is at risk of heart disease. One coronary angiogram she had done recently placed here in the 90th percentile rank.
“I’d love to be in the 90th percentile for most things in life, but that means that there’s only 10 percent of female at the age of 51 to 55 who have a higher calcium score than me.”
Dr Cara Wasywich, a cardiologist at Auckland City Hospital, told Rudkin and co-host Louise Ayrey on the latest Little Things episode that many women don’t put themselves first and don’t often think of their cardiovascular health, which contributes to their surprise when they learn they have issues.
She said that a range of factors contribute to heart disease in people, including genetics, while heart attacks can lead to further problems.
For women, they are more susceptible to certain conditions, such as “spontaneous coronary artery dissection”,
“It is a cause of heart attack in women, which is much more common in women than men. Itt does present often in patients who you wouldn’t normally expect to be at risk of cardiac disease, so younger women, for instance.”
Menopause is also a contributing factor in heart attack risks, Dr Wasywich said.
“High blood pressure is more common in women, a strong driver of heart disease, high cholesterol is definitely a problem for women, as well as for men.”
Dr Wasywich said that pregnancy is another time when women are first presented with cardiac issues.
“There’s a big increase in the cardiovascular disarm when you’re pregnant, you need to increase your cardiac output a lot. So there are a few people with occult heart disease who will present in pregnancy with new symptoms.
“If you have known cardiac disease, it’s obviously a big stress, and so people who have a cardiac problem are often closely monitored during pregnancy. And then there’s a few things that are more likely to occur in pregnancy like preeclampsia, pregnancy-associated hypertension, diabetes, a big risk for cardiac disease, and then these other rarer things like coronary dissection or actually aortic dissection for people with big aortas.”
Ultimately, a number of factors can put a woman at risk of heart disease, but there are many things that can be done to prevent it developing.
“Being at risk of heart disease is not the same as having heart disease,” Dr Wasywich said. “And so when we’re treating primary prevention, we’re trying to avoid a problem in the long term, and most patients want to do all that they can to reduce their risk.
“Actually having heart disease is when something’s happened or you have symptoms. And so having coronary calcification without angina, without having had in the past a heart attack, without having impairment of the heart pumping function, you don’t have heart disease. You are at risk of heart disease, and you’ve got a big opportunity to reduce your risk.”
Listen to the full episode of The Little Things for more on what you need to know about heart disease risks and how to tackle them, and what you need to know when things turn serious.
The Little Things is available on iHeartRadio, Apple Podcasts, Spotify or wherever you get your podcasts. The series is hosted by broadcaster Francesca Rudkin and health researcher Louise Ayrey. New episodes are available every Saturday.