I was born with something called pressure restrictive apical muscular ventricular septal defects. It sounds like a scary term, but it wasn’t until recently that I had learned the proper scientific term for it; when I was growing up I was told I had holes in my heart.
I had around eight of them and most of them closed on their own. Any others that did not close have had little to no impact on my life.
However, being born with a heart defect (and growing up with several other heart problems as a result) has made me a more conscious person around heart disease— but I believe everyone should be. Heart disease is the leading cause of death for women in the United States.
Moving forward, there are some important terms to know when you do your own heart health research.
CVD is short for cardiovascular disease, and is a catch-all for any condition that affects the heart or blood vessels. CHD and CAD are short for coronary heart disease and coronary artery disease, respectively. Health professionals will typically use these acronyms interchangeably, although CAD is a more specific term than CHD.
Primary prevention is a level of preventative methods that reduce risks to health. There are two other levels of prevention— secondary and tertiary— but primary is the preferred method of all health professionals. Primary prevention means preventing a disease before it even occurs through: legislation around mandating healthy practices and banning hazardous ones, education about healthy habits, and immunization against diseases.
The following article hones in on ASCVD, or atherosclerotic CVD. This is because atherosclerosis is the main underlying cause of CVD. Atherosclerosis refers to the buildup of plaque in blood vessels that can limit or block blood flow to the organs of the body.
In the article “Primary Prevention and Cardiovascular Risk Assessment in Women” by Lori-Ann Peterson, Priya M. Freaney & Martha Gulati released in 2022, they detail how “[over] 60 million women are living with some form of [cardiovascular disease], with a lifetime risk for a 40-year-old woman of 1 in 2 for developing any CVD, 1 in 3 for developing coronary heart disease (CHD), 1 in 5 for developing heart failure, and 1 in 5 for having a stroke”.
With those risks in mind, the article revealed how despite that women are not as informed about CVD risk as expected, and that even primary care physicians will not only “prioritize weight and breast health over concerns for CVD,” a lot of them even feel under-equipped to assess the risk for it, let alone implement risk prevention for women.
The article as well as other sources acknowledge that part of the reason why women are at higher risk for heart failure (in addition to traditionally categorized risk factors such as age and family history) is because “[even] though cardiovascular mortality rates were higher in women than in men in the United States, it was not until 1991 that the National Institute of Health (NIH) established a policy that all NIH-funded trials must include both women and men when studying conditions that affect both sexes”.
The authors of the article acknowledge that while both sex (determined at birth and is biologic, based on chromosome) and gender (based on sociocultural definitions and is nonbinary) can impact CVD outcomes, differences in sex impact CVD outcomes to a greater extent. This is due to a doctor’s lack of knowledge on how CVD impacts either sex and differences in treatment strategy.
ASCVD risk assessment in women focuses on sex-specifc and sex-predominant risk factors, honing in on menstrual history, pregnancy history, and menopausal history.
Outside of sex-specific and sex-predominant risk factors, though, health professionals still use traditional CVD risk factors to evaluate the risk in women and men alike. Here are some of the biggest:
Age
Age is one of the biggest risk predictors of CHD. Especially in women, where CHD events can be delayed up to at least 10 years in comparison to men.
Family History
A first-degree relative with premature CHD doubles the risk of a future cardiovascular event. It is more potent in a female first-degree relative than a male first-degree relative.
Hypertension
Hypertension (a.k.a. high blood pressure) is overall lower in women than it is in men. It should be noted that oral contraception can increase hypertension (7–8 mmHg).
Diabetes
Although diabetes rates are similar in men or women, diabetes raises a woman’s CHD risk by three to sevenfold. Fatal CHD in diabetic women is 3.5 times higher than in nondiabetic women.
Physical Activity/Fitness
Physical inactivity is widely reported among women of all ages. Although the article acknowledges “a gender bias in physical activity measurement instruments,” women also perform less leisure time physical activity when compared to that of men.
For those interested in learning more about this topic, more details and information are available in “Cardiovascular Risk Assessment in Primary Prevention,” edited by Michael D. Shapiro.
Take care of yourself, ladies!
How do you look after your own heart? Let us know on Instagram, @HerCampusSJSU!