Women and Heart Disease

Believe it or not, the number one killer of women is heart disease, formerly thought to be a “man’s disease”.

What is heart disease? 

Your heart is a muscle that gets energy from blood carrying oxygen and nutrients. Having a constant supply of blood keeps your heart working properly. Most people think of heart disease as one condition. But in fact, heart disease is a group of conditions affecting the structure and functions of the heart and has many root causes. Coronary artery disease, for example, develops when a combination of fatty materials, calcium and scar tissue (called plaque) builds up in the arteries that supply blood to your heart (coronary arteries). The plaque buildup narrows the arteries and prevents the heart from getting enough blood (Heart & Stroke Foundation).

Why does heart disease affect women?  Women are more likely than men to have coronary MVD. Many researchers think that a drop in estrogen levels during menopause combined with other heart disease risk factors causes coronary MVD.  The disease affects women differently than it does men.  This can cause many women to be misdiagnosed.  Here are the differences:

  • For women, heart disease symptoms may be subtle – but when a heart attack
    strikes, women are more likely to die than men. Women are also at twice the risk
    of death following open heart surgery, compared to men
  • Heart damage is more likely to occur in women when the small blood vessels become obstructed from plaque.
  • Women are also more likely to maintain heart function after a heart attack, unlike men whose heart muscle becomes weaker; 38 percent of women die from heart attack, making heart attack more lethal for women than men.
  • Women are also more likely to have a second heart attack within six years of their first one, unlike men.
  • Women are also less likely than men to have obstructive coronary artery disease.

Women are also more likely than men to have a condition called broken heart syndrome. In this recently recognized heart problem, extreme emotional stress can lead to severe (but often short-term) heart muscle failure.  Broken heart syndrome is also called stress-induced cardiomyopathy (KAR-de-o-mi-OP-ah-thee) or takotsubo cardiomyopathy.

Doctors may misdiagnose broken heart syndrome as a heart attack because it has similar symptoms and test results. However, there’s no evidence of blocked heart arteries in broken heart syndrome, and most people have a full and quick recovery.  Researchers are just starting to explore what causes this disorder and how to diagnose and treat it. Often, patients who have broken heart syndrome have previously been healthy.

Women’s College Hospital in Canada where I go offered the following differences between the sexes and the effects of heart disease:

Women Tend to Develop Heart Disease at a Later Age

Women tend to develop heart disease later in life because they are often (though not always) protected by high levels of estrogen until after menopause. Men’s risk of developing heart disease increases in their 40s. A woman’s risk of heart disease becomes similar to a man’s risk about 10 years after menopause.

Women Experience More Silent Heart Attacks

Women experience more silent heart attacks than men. That is, a woman may not know she has had a heart attack. Women are also more likely to have a single artery narrow whereas men tend to have multiple arteries narrow.

Women Are More Likely to Be Suffering from Other Health Problems

Women are more likely to be suffering from other health problems, such as diabetes and high blood pressure, when they have heart problems.

Women Do Not Always Get the Health Care They Need

Heart disease is under-detected in women. Once women do seek treatment, doctors do not always recognize their symptoms as the symptoms of heart disease. Women are also less likely to be referred to a heart specialist, to be hospitalized, to be prescribed medication or other treatment, or to be referred for exercise testing. As a result, women do not always get the health care they need.

I find it unsettling that women are not always getting the health care they need when they seek treatment for heart disease.  They should receive the same considered as men.  They should be referred to a heart specialist or hospitalized or given whatever care they should be entitled to.  It’s time for women to stop being under served and under treated.  In the mean time, educating women about their risk of the disease and how to take control of their health so that they can reduce that risk.  Whenever I go for my annual checkup, my doctor always orders an ECG for me.  Although I just read that ECG tests are not recommended by a government backed panel.  Read article.  Heart for Life has information on screening and heart tests on their website.  Check them out here.

I read that young women can have heart disease too.  Even though heart disease among women becomes more common after menopause, it affects younger women.  Every year in the U.S., heart disease kills about 16,000 young women and accounts for 40,000 hospitalizations in young women, according to the American Heart Association.  Young women may experience symptoms of a heart attack and fail to recognize them as such for the following reasons:

  • They thought they were too young to be having a heart attack.
  • They had atypical symptoms that lasted for more than a day.
  • They chalked up their symptoms to other conditions, not to a heart attack.

African American women are more at risk for heart disease than Caucasian women. And, if an African  American woman has a heart attack, she is 69 percent more likely to die of that  heart attack than a Caucasian woman.

Don’t be discouraged.  The Heart & Stroke Foundation assures us that heart disease is preventable and manageable.  They say that our defense is controlling the risk factors that could lead to coronary artery disease, such as high blood pressure, high cholesterol, diabetes, smoking, stress, excessive alcohol consumption, physical inactivity and being overweight.  Here are healthy heart steps we need to follow:

  • Be smoke-free.
  • Be physically active.
  • Know and control your blood pressure.
  • Eat a healthy diet that is lower in fat, especially saturated and trans fat.
  • Achieve and maintain a healthy weight.
  • Manage your diabetes.
  • Limit alcohol use.
  • Reduce stress.
  • Visit your doctor regularly and follow your doctor’s advice.

Let us take action today.  Let us keep our hearts healthy.

Women tend to think that breast cancer is their biggest health threat. And while it’s important, heart disease remains the No. 1 killer of women, even young women. But that message just hasn’t been fully recognized – cardiologist Nicea Goldberg, MD, director of the Women’s Heart Program at NYU Medical Center and author of the new book Complete Woman’s Guide to Women’s Health.

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Sources:  http://www.womensheart.org/content/heartdisease/heart_disease_facts.asp; http://www.webmd.com/heart-disease/features/women-and-heart-disease-key-facts-you-need-to-know; http://womenshealth.gov/publications/our-publications/fact-sheet/heart-disease.cfm; http://www.oprah.com/health/Facts-About-Heart-Disease-for-Women; http://www.reuters.com/article/2012/07/30/us-ecg-heart-idUSBRE86T1EE20120730; http://www.nhlbi.nih.gov/health/health-topics/topics/hdw/; http://www.emaxhealth.com/1020/heart-disease-affects-women-differently-men; http://www.womenshealthmatters.ca/health-resources/heart-health; http://www.modernmom.com/article/women-and-heart-disease-getting-the-right-health-care;  http://www.webmd.com/heart-disease/news/20080502/younger-women-miss-heart-attack-signs; http://www.heartandstroke.on.ca/site/c.pvI3IeNWJwE/b.4007287/k.4ACF/Heart_Disease__What_is_heart_disease.htm

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Women and HIV/AIDS

December 1, 2012 was World AIDS Day.  Different organizations such as Project Have Hope, SOS Children’s Villages, One Billion Rising and UNICEF Canada were raising awareness of a disease which has no cure.  Children are orphaned because of AIDS.  According to SOS Children’s Village, 33.3 million people live with HIV/AIDS and 3.4 million of those affected are children.  Lost, ostracized by family members and friends, these children are often forced to live on the streets in some of the most appalling conditions imaginable.

I remember watching the movie GIA with Angelina Jolie as Supermodel Gia Carangi who died of AIDS in 1986 at the age of 26.  She was addicted to heroin and other drugs.  She contracted HIV through a shared needle.  What a tragic movie it was to see someone so young and with a successful career spiral downhill because drugs had taken over her life.  She was thought to be the first famous woman to die of AIDS.

General Hospital’s Robin Scorpio came to mainstream attention during a 1990s story arc where her boyfriend Stone Cates dies from AIDS and Robin is diagnosed as HIV-positive.  Robin has since married Dr. Patrick Drake and the couple has a daughter, Emma, who, after a brief scare, is shown not to be infected by Robin’s HIV.

Even though there is way more information about the disease now than back in the ’80s, there are still some questions people have about HIV/AIDS.  Some of the frequently asked questions  are:

1. Are HIV and AIDS the same thing?

No. When someone is described as living with HIV, they have the HIV virus in their body. A person is considered to have developed AIDS when the immune system is so weak it can no longer fight off a range of diseases with which it would normally cope.

2. How is HIV passed on?

HIV is passed on through infected bodily fluids such as semen, vaginal fluids, blood, breast milk and rectal secretions. The most common ways HIV is transmitted are through sex without a condom and through sharing infected needles, syringes or other injecting drug equipment. You cannot get HIV through casual or day-to-day contact, or kissing, spitting or sharing a cup or plate.

3. Can you get HIV from oral sex?

The risk of HIV transmission from performing oral sex is low but it can still happen. It is best to avoid giving oral sex if you have cuts or sores in your mouth or bleeding gums, as this increases the risk of HIV entering your body.

4. How can I protect myself and others from HIV infection?

Always use a condom when having vaginal or anal sex. You may also want to use a condom or dental dam during oral sex although the risk of transmission of HIV is much lower. You can get free condoms from a sexual health clinic, which you can locate via the FPA website. Never share needles, syringes or any other injecting equipment.

5. What do I do if I don’t like using condoms?

Condoms have come a long way in recent years and you can now get condoms in different sizes, flavours, and with added features to increase pleasure and heighten sensation. Condoms are still the best way to protect yourself and others from HIV infection, and other STIs, so if you think you don’t like using condoms, it’s worth trying out some different varieties.

If you find using condoms or negotiating condom use difficult, it is worth speaking to your local sexual health clinic or GP.

Other questions are:

Will HIV definitely be passed on during sex between an HIV positive and an HIV negative person?

During sex, it is not an automatic consequence that HIV will transmitted. Compared with some other infectious diseases, risk of HIV infection from a single act of sex is usually low. But of course repeated acts of sex increase probability of transmission which is why it is important to have safer sex. Condoms are highly effective at preventing HIV from being passed on so condoms should always be used during sex to avoid HIV and other STIs.

There are other factors which can increase and reduce the risk of having sex with someone with HIV, but a condom is the safest and easiest way to prevent transmission and stay safe.

Is anal sex more risky than vaginal sex when it comes to HIV transmission?

HIV can be transmitted through both anal and vaginal sex, but in some circumstances there is greater risk involved in anal sex. This is because anal sex carries a greater risk of trauma (such as tearing of the skin and bleeding) which makes it easier for the HIV infection to get through.

What are the symptoms of early HIV infection?

The most common symptoms of early HIV infection, usually occurring around ten days after infection, are fever, rash and severe sore throat all occurring together. This combination of symptoms is unusual in healthy people and indicates the need for an HIV test.  70-90% of people experience symptoms of early HIV infection but some do not experience any. After two-three weeks these symptoms disappear, and someone with HIV may then live for many years without any further symptoms or indicators that they are HIV positive.

What should I do if I experience symptoms of early HIV infection?

If you experience the symptoms of early HIV infection — fever, rash and severe sore throat occurring at the same time — then you should get an HIV test as soon as possible. It could be just a bad case of flu, but there is also a risk it could it be the early signs of HIV infection so it always best to know for sure by getting tested.

Here are some facts that every woman should be aware of:

Women have a higher risk of getting HIV from vaginal sex

Women are more likely to get HIV during vaginal sex than men are for several reasons.

  • The vagina has a larger area (compared to the penis), that can be exposed to HIV-infected semen.
  • Semen can stay in the vagina for days after sex, while men are only exposed to HIV-infected fluids during sex. Semen left in the vagina means a longer exposure to the virus for women.
  • Having untreated sexually transmitted infections (STIs) makes it more likely for a person to get HIV. This is especially true for women. Small cuts on the skin of the vagina are hard to notice but may allow HIV to pass into a woman’s body.

Women can pass HIV to their partners

Many HIV-positive women with HIV-negative partners worry about passing HIV. Research shows in the United States, men pass HIV more easily than women do. But women can still pass HIV to uninfected partners — both male and female — through all kinds of sex. This is because HIV is in blood (including menstrual blood), vaginal fluids, and in cells in the vaginal and anal walls.

If you are HIV-positive, you can pass the virus at any time, even if you are getting treatment. But you may be more likely to pass the virus if:

  • You have a vaginal yeast infection or STIs
  • You have recently been treated for a vaginal yeast infection or STIs
  • You were recently infected with HIV
  • Your partner has an infection or inflammation

The surest way to avoid passing any STI, including HIV, is to not have sex. If you do have sex, it’s important to alwaysuse a male condom correctly and every time you have sex.

Click here to find out when you should get tested for HIV and the types of tests available.

According to the latest (2008) WHO and UNAIDS global estimates, women comprise 50% of people living with HIV.

In sub-Saharan Africa, women constitute 60% of people living with HIV. In other regions, men having sex with men (MSM), injecting drug users (IDU), sex workers and their clients are among those most-at-risk for HIV, but the proportion of women living with HIV has been increasing in the last 10 years.

This includes married or regular partners of clients of commercial sex, IDU and MSM, as well as female sex workers and injecting drug users.

Gender inequalities are a key driver of the epidemic in several ways:

Gender norms related to masculinity can encourage men to have more sexual partners and older men to have sexual relations with much younger women.

Violence against women (physical, sexual and emotional), which is experienced by 10 to 60% of women (ages 15-49 years) worldwide, increases their vulnerability to HIV.   Forced sex can contribute to HIV transmission due to tears and lacerations resulting from the use of force.

Gender-related barriers in access to services prevent women and men from accessing HIV prevention, treatment and care.  Women may face barriers due to their lack of access to and control over resources, child-care responsibilities, restricted mobility and limited decision-making power.

Women assume the major share of care-giving in the family, including for those living with and affected by HIV. This is often unpaid and is based on the assumption that women “naturally” fill this role.

Lack of education and economic security affects millions of women and girls, whose literacy levels are generally lower than men and boys’.

Many national HIV/AIDS programmes fail to address underlying gender inequalities. In 2008, only 52% of countries who reported to the UN General Assembly included specific, budgeted support for women-focused HIV/AIDS programmes.

Virgin cleansing is the mistaken belief or myth that if a man infected with HIV, AIDS, or other sexually transmitted diseases has sex with a virgin girl, he will be cured of his disease.  Anthropologist Suzanne Leclerc-Madlala has recognized the myth as a potential factor in infant rape in South Africa.  Anthropologists Nora E. Groce and Reshma Trasi identified a variation of the practice of the virgin cleansing myth whereby individuals who are “blind, deaf, physically impaired, intellectually disabled, or who have mental-health disabilities” are raped under the erroneous presumption that individuals with disabilities are sexually inactive and therefore virgins.  It is most prevalent in Zimbabwe where the myth is perpetuated by traditional healers advising HIV-positive men to cure their disease by having sex with virgin girls.  Because of the virgin cleansing myth, as many as ten girls are raped every day. As many as 3,600 girls in Zimbabwe each year may be contracting HIV and AIDS after being raped.  UNICEF has attributed the rape of hundreds of girls to the virgin cleansing myth.   Cases have been reported in which a one-day-old infant was raped.  This is a practice that needs to be banned–abolished.  And gender inequality needs to be addressed so that women living with HIV/AIDS will get the treatment they need and not have to live with the stigma and shame.  Education and prevention are key to the fight against this epidemic and the organization amfAR founded in 1985, is doing this through innovative research.  Read here for the sobering statistics of women and HIV/AIDS in the United States and around the world.

This a disease that doesn’t discriminate.  I have read stories of women who contracted HIV from their husbands.  I read stories of women who contracted HIV from birth or from childhood.  HIV/AIDS affect single women, engaged women, married women, women of all races, ages, cultures, backgrounds, etc.  Many of those who found out that their partners, boyfriends, fiances and husbands were positive were devastated and afraid to get tested again for fear of the results.  Many of them contemplate suicide because they can’t face life with this disease.  Mothers worry about leaving their children and pregnant women worry about passing it on to their unborn children.  We all know that abstinence is the safest way to go but what do you say to a woman who at the age of 40 is still a virgin because she wants to preserve herself for her husband, finally meets the man of her dreams, they marry and then later down the road she finds out that he is HIV positive?  Her life is turned upside down.

I read that even though more men than women have HIV, infections among women is on the rise.  the greatest rates of infection occur among women of color (especially African American women). Younger women are more likely than older women to get HIV.   AIDS is second only to cancer and heart disease for women.

What can women do?

Get educated!  Educate yourself about the different ways that you can acquire HIV and then all the ways to protect yourself. Learn your status so that you can protect yourself and your partners.  Teach those around you about how HIV can be transmitted and how you can protect yourself from infection.  Work in your community to improve awareness.  You and your partner should get tested for HIV and other STDs so that you are aware of each other’s status before you have sex.  If you are a pregnant woman, it is especially important that you get tested early to help ensure, that if you are HIV positive, you do not transmit the virus to your unborn child.  Talk about HIV and other STDs with each partner before you have sex.  Ask your partners if they have recently been tested for HIV; encourage those who have not been tested to do so. Use a latex condom and lubricant every time you have sex.  Get tested for HIV once a year.

The good news is that many women with HIV are living longer and stronger lives. With proper care and treatment, many women can continue to take care of themselves and others.

Let’s continue to do everything we can to make HIV/AIDS history.

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Sources:  http://www.hivaware.org.uk/be-aware/faqs.php; http://www.womenshealth.gov/hiv-aids; http://www.who.int/gender/hiv_aids/en/; http://www.amfar.org/about_hiv_and_aids/facts_and_stats/statistics__women_and_hiv_aids/; http://hiv411.org/page.php?pID=30; http://en.wikipedia.org/wiki/Gia_Carangi; http://en.wikipedia.org/wiki/Virgin_cleansing_myth