Understanding Cardiovascular Risk in Indian Women

Cardiovascular diseases (CVDs) account for over a quarter of adult deaths in India, making heart health a crucial topic, especially for women. Despite misconceptions, women are at significant risk for heart disease, and they often exhibit different symptoms than men.

According to the World Health Organization (WHO), CVDs are the leading cause of death among adult women in India. The National Family Health Survey (NFHS-5) 2019-20 noted that 0.7% of women across India reported heart disease compared to 0.9% of men. However, this slight difference in self-reporting underestimates the actual cardiovascular risk women face. Understanding these risks and utilising advanced screening modalities can be crucial for early detection and prevention.

The Heart Health Landscape for Indian Women

Women face unique risk factors for heart disease, including non-communicable diseases (NCDs) like diabetes, hypertension and obesity, and hormonal changes during menopause, gestational diabetes, and conditions like polycystic ovary syndrome (PCOS). Indian women also tend to develop heart disease a decade earlier than their Western counterparts, underscoring the need for early awareness and intervention.

• High Prevalence of NCDs in India: One of the primary risk factors for heart disease in India is the high prevalence of diabetes, hypertension, and obesity. As the second-largest diabetic population in the world, Indian women are especially vulnerable. Obesity rates, poor dietary habits, sedentary lifestyles, and increasing stress levels compound these risks.

• Unique Risk Factors in Indian Women: PCOS affects a significant number of Indian women and is associated with insulin resistance, obesity, and an increased risk of developing type 2 diabetes — all of which heighten cardiovascular risk. Early menopause, common in Indian women, brings hormonal changes that elevate cholesterol, blood pressure, and heart disease risk. Additionally, women with gestational diabetes are at higher risk of developing heart disease later in life.  

Go Beyond Routine Heart Health

When it comes to assessing heart health, most of us are familiar with routine tests like the lipid profile and ECG (electrocardiogram). While these tests provide essential insights, they often don’t tell the full story about your cardiovascular health. Lipid profiles measure cholesterol levels, and ECGs monitor electrical activity in the heart, but they may not give a complete picture of heart function.

To truly assess heart health, more comprehensive testing is needed:

• ECHO (Echocardiogram): An ultrasound that assesses your heart’s structure and measures how well it pumps blood
• Treadmill Test (TMT): Measures how your heart performs under physical stress
• Apolipoproteins A and B: These biomarkers give a more detailed understanding of cholesterol’s role in heart disease, especially when traditional tests seem normal.
• Plaque Imaging: Provides a direct look at the build-up of fatty deposits (plaques) in your arteries, helping doctors identify and treat cardiovascular risks early.

By combining these tests, healthcare providers can offer a comprehensive, personalised assessment of your heart health.

Barriers to Early Detection

Despite the rising risk of heart disease among Indian women, several barriers exist that prevent early detection and timely treatment:

• Lack of Awareness: Many women and healthcare providers do not fully recognise the signs of heart disease in women. Symptoms like fatigue, shortness of breath, and nausea can be mistaken for less severe conditions, delaying crucial intervention.
• Low Screening Rates: Regular heart check and advanced screenings are often not part of routine healthcare for women.
• Cultural and Societal Norms: Women, with their multitasking nature, typically tend to prioritise the health of their family over their own well-being. As a result, they may delay seeking medical attention, even when experiencing symptoms of heart disease.

Mitigating Women’s Inherent Risks

Despite these risks, Indian women can take steps to protect their heart health:

• Healthy Diet: Prioritise a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Limiting salt, sugar, and unhealthy fats can significantly benefit your heart.
• Regular Exercise: Aim for at least 150 minutes of moderate exercise each week. Physical activity helps manage weight, reduce blood pressure, and improve overall heart health.
• Manage Stress: Chronic stress can elevate the risk of heart disease. Women should incorporate stress-relieving practices such as mindfulness, meditation, or hobbies into their daily lives. Prioritising mental health is just as important as physical well-being.
• Avoid Smoking: Smoking is a major risk factor for heart disease. Quitting can dramatically reduce your risk.
• Routine Checks: Regular monitoring of key health indicators like blood pressure, cholesterol levels, and blood sugar is essential.

Let’s prioritise our heart health by understanding our unique risks as women. Remember, a healthy heart today means a healthier, longer life tomorrow. Let’s get informed, get tested, and stay heart-healthy!