A local information session about a lesser known but serious women’s health risk drew some attention on Feb. 13. 

Activist group Citizens of the Pontiac organized an online presentation about women’s heart and vascular disease, which was streamed to audiences gathered at both the Community Lodge in Shawville and the Mansfield CLSC. 

The presentation, given by Nadine Elias from the Canadian Women’s Heart Health Alliance,  was hosted in conjunction with Wear Red Canada day to raise awareness about the rise and risks of this condition, and the challenges for women when it comes to getting it diagnosed. 

“Many Canadian women die prematurely because they had not known the signs of heart disease nor did they know that heart disease behaves differently in men than it does in women,” wrote Citizens of the Pontiac spokesperson Judith Spence in an invitation to the event. 

In her presentation, Elias said despite the fact that more women than men now die of heart disease, and that five times as many women die from heart disease as do from breast cancer, it is still severely under-researched, under-diagnosed and under-treated in women. 

“Significant sex- and gender-related differences and disparities exist, affecting the awareness, the disease progression, and the diagnosis and treatment.”

She highlighted the fact that despite women accounting for just over half the population, two thirds of heart disease research has been historically focused on men. Because of this, diagnostic and treatment strategies have been based on how heart disease shows up in middle-aged white men, which can be quite different from how it shows up in women. 

“This gap in research has contributed to a lack of understanding of the sex-specific symptoms and treatment responses in women,” Elias said. 

One of the consequences of this is that early heart attack signs are missed in 78 per cent of women, and misdiagnosis is especially common in younger women who often don’t experience the more common symptoms like extreme chest pain. Doctors often focus on other possible causes without ruling out heart problems. 

Part of the challenge, she said, is that women and men show different symptoms of heart disease. Beyond sharp chest pain or tightness, women also experience more subtle symptoms like nausea or heartburn, pain in the jaw, neck, right arm or back, extreme sweating, shortness of breath, unusual fatigue and weakness, lightheadedness and heart palpitations. 

Importantly, women are more likely to present with three or more symptoms in addition to chest pain. 

“Usually women will experience a few symptoms at the same time, but when in doubt, check it out,” Elias said. 

The lack of awareness of the possible connection between these symptoms and heart disease means many women don’t consider that they may be at risk, especially because women may develop forms of heart disease that are less common in men. 

The most common types of heart and vascular disease include cholesterol build-up in the heart’s blood vessels (coronary artery disease), leaky or stiff heart valves affecting blood flow (valvular heart disease), and an irregular or rapid heartbeat (arrhythmia). 

But women are also prone to other heart and vascular challenges, including a tear in the heart’s large blood vessels, a tightening of the heart’s large blood vessels, small vessel disease, a weakened heart due to a stressful event, or a weakened heart during or after pregnancy.

Female-specific risk factors

Elias pointed to several conditions that lead to a greater risk of heart disease in women, including certain pregnancy complications, menopause before the age of 45, ovarian cysts and hormonal imbalances, and inflammatory and autoimmune disorders. 

The more common risk factors including diabetes, obesity and smoking cigarettes are more likely to cause heart disease in women than they are in men. Female smokers, for example, have a three times higher risk of heart attack than men. 

But Elias was adamant in emphasizing that 80 per cent of heart disease is preventable and can be changed by managing risks including diet, cholesterol, blood pressure and mental health. 

She recommended reducing chronic stress, getting at least 30 minutes of exercises a day, cooking more meals at home to avoid processed foods, limiting alcohol and tobacco consumption, and getting regular check-ups with your doctor. 

She said everyone who is over the age of 40 or post-menopausal should have an assessment done every five years. 

“And if you are having symptoms, demand that a heart attack be ruled out,” Elias said.