Advances in medical technology, public health measures (including the earlier detection of some illnesses) and healthier lifestyles have contributed to a longer life for many people. They have also led to changes in the causes of death.
For example, Australian Bureau of Statistics (ABS) data shows that between 1998 and 2008 there have been decreases in the standardised death rates for Ischaemic heart disease as well as for Stroke, which were Australia's top two leading causes of death during that period. But while the number of deaths from IHD or Stroke has declined, they are still the top two causes followed by dementia and lung cancer.
A new study published recently in The Journal of the American Medical Association has also found that many people who are taken to hospitals for heart attacks never have chest pain. This is particularly the case for women.
The study of 1.1 million people by a consortium of medical researchers in the United States and China found that 42% of women admitted to hospitals for heart attack never had chest pain. By comparison, 31% of men who were admitted didn’t experience chest pain. The study also found that the mortality rate for these women was 15% compared with 10% for men.
“We think part of the reason is that women who are presenting with a heart attack might not have that classical presentation,” said Dr John G. Canto, director of the chest pain center at Lakeland Regional Medical Center in Florida and one of the study’s authors. “So they may not be recognised as having a heart attack, and possibly some of these patients may present too late to receive lifesaving procedures.”
Until the 1980s, many studies of heart disease tended to focus only on men with the typical signs of heart attack including chest pain, shortness of breath and radiating pain in the neck, back, jaw and arms. But further research in the 30 years since has shown that while female heart patients may exhibit these symptoms, they are also more likely to show symptoms that are not necessarily associated with heart attacks – such as sleep disturbances and severe unexplained fatigue in the days and weeks prior, as well as cold sweats, weakness and dizziness during the attack – generally in the 3-4 weeks prior to a heart attack.
No one knows precisely why heart attack symptoms differ between men and women, but Dr Canto speculated that many factors may be involved, including hormones.
“We also know that in women, especially young women who have heart attacks, the mechanism of blood clot formation in the heart artery may be different than in young men,” he said.
According to Dr Canto, those who are having a heart attack but do not feel tightness or pain in the chest may not realise what is happening and when they do show up for treatment, doctors may not immediately consider the possibility of a heart attack, particularly in women. As a result, the odds of immediately undergoing bypass surgery, heart catheterisations and other lifesaving procedures are decreased.
The reality is that many doctors tend not to think that younger women have heart attacks, said Dr Mario Garcia, chief of cardiology at the Montefiore Einstein Center for Heart and Vascular Care in New York. But it’s also known from other studies that even women who do experience classic symptoms of a heart attack, including chest pain, are less likely to seek medical attention than men.
“Men are quick to rush to see a physician. But women worry more about their husbands than themselves.”
The good news is that heart disease (and stroke) are largely, but not always, preventable. There are some things you can’t do anything about, such as your age and the history of heart disease in your family, but others that you can. These include:
- smoking
- inappropriate drinking
- physical inactivity
- being overweight
- social isolation or depression
- high blood pressure
- high cholesterol
Medical experts believe there are 5 things everyone can do today to help prevent heart disease.
- Do not smoke
- Exercise for at least 30 minutes a day
- Maintain a healthy weight
- Have a heart-healthy diet
- Get screened for cholesterol, diabetes and high blood pressure when you visit the GP
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