Living with heart disease risk
Although the vast majority of Canadian women don't realize heart disease and stroke are enemy No. 1, Marlies Caswell wasn't one of them. Since both of her parents had heart disease (her mother died of a heart attack at 61), she made a point of eating healthily and exercising regularly.
When she turned 40, she reminded her doctor about her family history, and he decided to send her to a cardiologist once a year to get tested for any signs of heart trouble. But what she didn’t know is that one of the major tests used to detect heart disease, the stress test, doesn’t work as well in women as it does in men. No one knows why.
When Marlies turned 50, her cholesterol shot up. Her doctors told her the jump was likely the result of hormonal changes (although she hadn’t yet hit menopause), and put her on Lipitor, a cholesterol-lowering drug. She carried on without too much worry, raising her daughter and working full time as a marketing manager with a national wine and spirits company in Vancouver.
“I’d never experienced one sign anything was wrong,” she says. “Even though I’d had two parents with heart disease, I still thought I had this beat.”
The truth is in the tests
A year later, at her annual heart checkup, an astute cardiologist noted her risk factors. He sat her down, and despite a pass on her latest round of tests, asked if she would mind if they did an angiogram (a dye test that reveals blockages in major arteries). “I thought maybe they’d find a 20 per cent blockage in one artery, give me some medication, and I’d be fine,” says Marlies.
The situation was much more dire. The test showed three of her arteries were badly blocked, and a heart attack was imminent. She needed triple-bypass surgery. “When I found out they were going to operate on the most important organ in my body, I was naturally very frightened,” says Marlies. A few months later, after a successful surgery and recovery, she would count her lucky stars that the cardiologist had bothered to probe further that day.
The difference between men and women
Statistics show that women face significantly worse odds than men do when it comes to heart disease and stroke: women are 16 per cent more likely to die from a heart attack, and stroke kills 45 per cent more women than men.
To add insult to injury, only 32 per cent of women are referred to a cardiologist following a heart attack, compared to 38 per cent of men, and women are almost three and a half times less likely to receive bypass surgery.
Experts agree a number of culprits are at play – misinformation, biology, age – but they all agree on one lifesaving truth: knowledge is power. Having an action plan enables women to prevent heart disease, as well as recognize its symptoms, while ongoing research gives us hope for better diagnostic tools and treatments that will close the gender gap.
“Men and women are more similar than dissimilar when it comes to heart disease,” says Dr. Beth Abramson, a cardiologist and associate professor of medicine at the University of Toronto. That being said, one significant difference is that most women are “protected” from heart disease, possibly by their hormones, until menopause, after which their risk catches up to men’s. But experts don’t know why.
