Heart of the matter: Cardiovascular diseases a huge concern for Indians

Heart diseases have emerged as the leading cause for fatalities in men and women in India and world over. Like all matters of heart, the risk of heart diseases to both sexes is grave, but then, heart diseases affect men and women differently. 

Of the more than one crore annual deaths are reported in India, cardiovascular diseases (CVD) account for 20.3% deaths  in men and 16.9% deaths in women.But there does not seem to be a conclusive understanding of whose heart is more at risk. While associating higher risks of cardiovascular diseases with a particular gender needs years of extensive study, there exists various physiological aspects of how heart diseases affect differently to men and women. The biology and physiology of both men and women are significantly different, which defines how we cope with various diseases. 

Cholesterol blockages: The deposition of cholesterol in the arteries of heart occurs more in the surface of the large arteries of heart, while in women it occurs in smaller vessels. This creates false indications of heart attack in women only to be revealed that the major arteries are doing fine. Just that the small are getting affected early due to cholesterol deposits does not mean the patient isn't at risk.  They may prove to be silent killers as symptoms may not be as pronounced as they are in the case of large arteries. Comparatively, bypass surgeries are easier to be performed in major arteries.

Lifestyle changes and their effects. In the past decade things have changed a lot, with coronary artery diseases (CAD) appearing in the younger age group. Lifestyle changes have impacted women's health in India in a big way. Sedentary lifestyle is a major factor, along with stress and bad dietary practices, smoking and consumption of oral contraceptives. In comparison, the development of CADs at a younger age has increased in men. Earlier men used to develop heart diseases at the age of 50 years. Now more men in their late 20s develop cardiac ailments.

Coping with stress: The presence of higher levels of oxytocin in women enables the fairer sex to be better at coping from stress hormones, such as cortisol and epinephrine, which together shoot-up the blood pressure and sugar levels. Also, women cope with stress by emotional responses, including tender and befriending responses, which is traditionally lacking in men who often display fight or flight responses. However, in Indian context, women usually act as caregivers and their health takes a backseat in the family. This prevents early medical consultation and diagnosis.   

Experiencing symptoms: Men typically get the classic pattern of angina with pain in the left side of chest, while women are more likely to have atypical angina, wherein they experience discomfort in the shoulders, back and neck. 

It is important for both genders to understand that fundamentals of cardiac health remain the same. Preventing associated factors, such as obesity, hypertension, high cholesterol levels and diabetes from developing; avoiding tobacco and alcohol consumption as much as possible, following healthy dietary patterns and, most importantly, exercising and increasing physical activities can significantly reduce the risk of heart ailments.

Vanita Arora, Director and Head, Cardiac Electrophysiology Max Super Specialty Hospital, Delhi