Heart attacks in women: why is the number of cases increasing and how can we limit the risks? A cardiologist answers: Femme Actuelle Le MAG

The number of myocardial infarctions continues to increase among young women. “30% of victims under 55 are women, compared to 13% in 1999. confirms Professor Claire Mounier-Véhier, cardiologist at Lille University Hospital. And hospitalizations are increasing by 5% per year among those aged 45 to 54.” Result : myocardial infarction is the leading cause of death among women, while cancer has supplanted it in humans. An update on the reasons for such a leap and the measures to put in place to protect your heart.

What exactly is a heart attack?

Myocardial infarction is the consequence of obstruction of the coronary artery (which supplies the heart with blood and therefore oxygen) by a fatty plaque partly made up of “bad” cholesterol (LDL-cholesterol). The crisis requires calling Samu (15) or 112 for immediate hospitalization in order to reopen the artery (coronary angioplasty).

The reasons for the increase

– A new combination of risk factors. Smoking, high blood pressure, type 2 diabetes, overweight/obesity, sedentary lifestyle/lack of physical activity… After the age of 45, eight out of ten women have at least two risk factors. A study published in 2023 in the United States even indicates that hypertension affects women more often (61% compared to 48% in men), as does obesity (27% compared to 15%) and diabetes mellitus. They also smoke more (56% compared to 50% for men).

– Risks specific to women. Early (before age 11) or late periods (after age 15), early menopause (before age 45), polycystic ovarian syndrome, hypertension or gestational diabetes of pregnancy: “these are all cardiovascular risk factors but are increasingly better managed“, assures Professor Martine Gilard, interventional cardiologist at Brest University Hospital.

– Greater vulnerability. At the same level of high blood pressure, a woman will have more cardiovascular events than a man. Same thing for diabetes where, for an identical blood sugar level, women will have twice as many cardiovascular complications. Finally, the same goes for cholesterol levels. An increased fragility of the wall of female vessels would explain this increased risk, to be confirmed.

– Less optimal patient care.In 1995, hospital mortality following a heart attack was around 18%.indicates Professor Martine Gilard. Thanks to all the progress made, it has fallen to 6%. But these improvements mainly benefit men. A recent French study points out, for example, less use by women of emergency numbers.In 92% of cases, however, they feel the brutal vice-like pain in the chest which radiates to the left arm and jaw.indicates Professor Gilard. But hearing that they don’t show the same signs as humans, many of them don’t worry!” Even more worrying, 18% of the women concerned do not benefit from “myocardial reperfusion” (the arteries of the heart are unblocked by angioplasty) compared to 11% of men.

Some atypical symptoms

In 8% of cases, women – especially older ones – feel symptoms different from those in men : a feeling of exhaustion or extreme fatigue, progressive shortness of breath with exercise, acute pain in the upper back or neck, palpitations, cold sweats and digestive symptoms (nausea, discomfort or heartburn.. .).

The solution lies in prevention

Eight out of ten cardiovascular accidents are preventable. Hence the importance of listening to yourself and taking care of your healthy lifestyle.

– Screen and control risk factors (diabetes, hypertension, overweight). All diabetes must be well controlled and weight loss must be recommended in cases of overweight, by rebalancing the diet. Finally, hypertension must be contained, that is to say less than 135 mmHg for systolic blood pressure and 85 mmHg for diastolic blood pressure (values ​​obtained with a blood pressure self-measurement device).

– Practice cardiac coherence. “THE psychosocial stress represents more than 30% of the risk of heart attackassures Dr Jean-Pierre Houppe, cardiologist. However, twice as many women as men suffer from it.” This chronic stress stimulates the secretion of cortisol, a hormone which tires the immune system and makes the organs more fragile. To protect them, we can practice cardiac coherence for several minutes. Simply breathe while exhaling twice as long as inhaling. Smartphone apps are available.

– To walk ! As Emily Martineau, of the French Federation of Physical Education & Voluntary Gymnastics, points out, “too few women reach the WHO recommendations for physical activity (150 minutes/week)”. They are 53% compared to 70% of men. And it is especially those aged 40-54 who have slowed down (- 22%). However, in case of risk factors for heart attack, running is not recommended. “We rather recommend active walkingindicates Professor Gilard. To bypass the narrowed vascular area, a sort of natural bridging will thus be created, that is to say that a “neovessel” will be born. And thanks to this peripheral circulation, the walker will avoid a heart attack in the event of rupture of the atherosclerotic plaque in the main artery..”

Post-infarction rehabilitation is essential

After a cardiovascular accident, it is important to follow a rehabilitation program in a specialized center (exercise retraining, lifestyle rebalancing, therapeutic education), with the aim of limiting recidivism. Women participate too little (one in five on average), claiming a lack of time due to family or professional responsibilities.

SCAD, the heart attack of young women

Nine out of ten victims of spontaneous coronary artery dissection (SCAD) are women in apparent good health. “There SCAD can occur at any time, especially after pregnancyspecifies Professor Gilard. It is believed to be a disease of the arteries, but it is currently poorly understood and therefore often underdiagnosed. In order to assess the risk of recurrence, scans of the patient’s other arteries (carotidsrenal, etc.) are systematically carried out after SCAD to assess the general condition.”

Read also :

⋙ Heart attack in women: what are the symptoms (different from men) to absolutely spot?

⋙ Heart attack: “I was told it was an anxiety attack, in fact I had had two cardiac arrests”

⋙ Cardiovascular diseases on the rise among women: experts tell us how to protect ourselves

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