Women and coronary heart disease

Most people think of men, not women, as having heart attacks. But coronary heart disease is the biggest single cause of death for women in the UK.


Statistics


In 1993, 76,000 women died of coronary heart disease in the UK, compared with 100,000 men.
About 1 in every 4 women in the UK dies from coronary heart disease. Although most of the deaths are women over the age of 65, nearly 6,000 women die each year before the age of 65. Death from coronary heart disease began to fall slightly after the late seventies for both men and women, but deaths among the wives of manual workers have actually increased.
As well as the deaths from coronary heart disease, many thousands of women suffer pain and disability. Although women have fewer heart attacks than men, they are only slightly less likely to suffer from angina – the narrowing of the coronary arteries which can cause a heavy pain across the chest.


Cutting down the risks


It seems likely that most of the risk factors which apply to women: cigarette smoking, high blood pressure, diet and lack of exercise. Women are at particular risk of coronary heart disease if they take the contraceptive pill, and women who smoke and take the pill are ten times more likely to die of a heart attack or stroke than non-smoking women who are not on the pill.
Some people have suggested that as more and more women take on paid work, coronary heart disease deaths among women will increase because of work related stress. However, research carried out in the United States found that, in general, women in paid employment had roughly the same rate of coronary heart disease as women working at home. The women who did have a slightly higher risk were those who worked in low-paid clerical jobs.


Women and prevention


Much of the advice on prevention of coronary heart disease has been oriented towards men. Advice to women is usually about what they could do to reduce their husband’s or children’s risk of coronary heart disease rather than their own.


Healthy eating


Women are often told that in choosing food for the family, they have their family’s hearts in their hands. But in reality, husbands and children are often in control – they simply refuse to eat certain foods. Many women end up feeling guilty as they try to reconcile healthy eating advice with their family’s habits. And sometimes the only way to avoid a family fight is to give in and give them chips.
Some healthier snacks to try are:
* Low fat crisps, or better still dried fruit and nuts instead of ordinary sweets
* Fruit instead of sweets
* Tea cakes or scones (preferably wholemeal) instead of biscuits
* Fruit juice instead of fizzy pop


Smoking


Although millions of people in the UK have given up smoking, men are giving up faster than women. From 1982 to 1992, the percentage of male smokers fell from 38% to 29%, but during the same period, women’s smoking only went down from 33% to 28%.
Anti-smoking education for women has often been aimed at pregnant women, and the emphasis is on protecting the baby rather than the women’s health.
Men and women have different reasons for smoking, and different problems when it comes to giving up. One of the biggest problems for women trying to give up is the fear of putting on weight. It seems that women are more likely than men to smoke in order to reduce feelings of anxiety or anger. Some women worry that if they gave up smoking they might not be able to suppress their angry feelings.


Overall there is an urgent need for more research into the causes of coronary heart disease in women in order to find more practical ways of helping women to reduce their risks of coronary heart disease.