Every year, in Portugal, there are about four thousand more women dying of CVD when compared to men. Even more worrying is the high incidence of acute myocardial infarction in young women.

Despite these figures, the risk of CVD in women continues to be inadequately identified, underappreciated and understudied. There are several reasons for this fact: poor awareness of this problem on the part of women and society in general, but also by the medical and scientific community; samples of scientific studies concerning women are, in most cases, small in number, making comprehensive conclusions difficult; symptoms of CVD in women are less explicit, which results in a correct and timely diagnosis being postponed or camouflaged; some studies report that women adhere less to treatment and that they are also less vigilant when it comes to their health.

As far as risk factors are concerned, some are transversal to both sexes and yet others that are markedly female.

Among the former are arterial hypertension; dyslipidaemia; sedentary lifestyle; smoking; diabetes mellitus and obesity, which have a different prevalence and importance in women. The prevalence of obesity and sedentary lifestyle for example, is higher in women. When these risk factors are associated also with smokers and/or with diabetes, the cardiovascular risk increases.

Cardiovascular risks associated with women include: hormonal (related to oestrogen levels: early menopause, hormone replacement therapy, polycystic ovary syndrome); conditions associated with pregnancy (eclampsia, gestational diabetes, preterm delivery, termination of pregnancy and intrauterine growth restriction); autoimmune diseases (systemic lupus erythematosus and rheumatoid arthritis); therapies associated with breast cancer (chest wall radiation and chemotherapy-associated cardiotoxicity) and psychosocial factors such as depression.

It is important to remember that the transition to menopause is a period of accelerated cardiovascular risk, associated with dyslipidaemia and deposits of atheromatous plaques on artery walls, that is, a set of alterations in blood fat levels that accelerate the process of fat deposition in the blood vessels (atherosclerosis) which cause CVD and is characterized by relatively normal LDL (“bad” cholesterol) but low HDL (“good” cholesterol) and high triglycerides.

To counteract this reality, it is necessary to focus on prevention, as well as learning to identify and interpret the risk factors and symptoms of these diseases in women at an early stage. Last but not least, women should also improve their level of literacy on this subject and above all monitor the health of their heart more closely.

For more information contact Grupo HPA Saude at +351 282 420 400.