Heart health advice for women - tips from a cardiologist

Six things I would never do as a female cardiologist

12 October 2023

With three in 10 Australian women dying from cardiovascular disease, heart health is something women can’t afford to ignore.

Through my work as a scientist at the Victor Chang Cardiac Research Institute in Sydney, and as a cardiologist, I’ve witnessed how heart disease can impact women with devastating consequences.

Knowing what I know, there are a few simple things that I would never do and if you want to protect your own heart, I’d urge you to follow suit.

1. I would never… think it can’t happen to me because I’m ‘healthy’

You run, eat well, don’t smoke, and maintain a healthy weight so clearly you have little to worry about when it comes to heart disease. Unfortunately, that’s not entirely true. There are many heart conditions that are caused by genetics or other factors aside from modifiable lifestyle factors.

Certain heart conditions are strongly influenced by our genetics and can therefore strike healthy women in their prime. Conditions such as hypertrophic cardiomyopathy (HCM), which causes thickening of the heart, is one of the leading causes of sudden cardiac death in young people. Other conditions, like familial hypercholesterolemia, a genetic disorder that causes high cholesterol in otherwise healthy individuals, may only be identified during a routine cholesterol test.

Spontaneous coronary artery dissection (SCAD) is another heart condition that occurs mostly in relatively young women (average age 45-52 years), the majority of whom are healthy with a low prevalence of the traditional risk factors for heart disease such as diabetes, smoking, or high cholesterol. SCAD is responsible for approximately 25% of heart attacks in women under the age of 50 and is the most common cause of heart attacks associated with pregnancy. The Institute is currently undertaking SCAD research, with more than 500 SCAD survivors volunteering to take part in our SCAD studies and breakthroughs are being made in understanding the genetic causes of SCAD.

So, while living a healthy lifestyle is important for everyone, you should also aim to be aware of your family history and have regular heart health checks, that assess your blood pressure, cholesterol, and blood sugar levels, to ensure any issues are identified early.

2. I would never… ignore the importance of sleep

Most people are aware of the role a healthy diet and exercise plays in heart health, but one of the lesser-known lifestyle risk factors for heart disease is poor sleep.

A lack of sleep (less than seven hours), or too much sleep (more than nine hours), increases the risk of obesity, high blood pressure, diabetes, and cardiovascular disease.

Almost 60 percent of adult Australians suffer from at least one chronic sleep symptom, so now is the time to work on your sleep hygiene. Your heart will thank you.

3. I would never… disregard the diet and exercise advice for a healthy heart

We really should be active on most (preferably all) days and minimise long periods of sitting or lying down. The World Health Organisation (WHO) recommends adults participate in at least 150-300 minutes of moderate-intensity aerobic physical activity; or at least 75-150 minutes of vigorous-intensity aerobic physical activity; or a combination of moderate- and vigorous-intensity physical activity during the week.

Eating a variety of fresh foods and minimising processed foods is also essential. Your specific dietary requirements will depend on your individual situation, but the WHO recommends a diet rich in vegetables and fruit, using unsaturated fats rather than saturated fats, and limiting refined sugars.     

4. I would never… drink alcohol to excess

While a glass of wine a couple of nights a week is little cause for concern, the impact of regular drinking is well-documented.

Research has shown that abstaining or just having one drink a day is associated with the lowest risk of cardiovascular disease, while peak health body the World Heart Federation has advised the less alcohol a person consumes, the better it is for their health.

This is particularly true for those with cardiac issues such as cardiomyopathy, cardiac rhythm issues, and other genetic cardiac problems, where the consumption of alcohol is likely to be detrimental at any amount.

5. I would never… ignore any symptoms of heart disease or assume the signs of a heart attack are the same for women and men

Early detection is crucial in preventing other health consequences of heart disease. This is particularly true for women, whose symptoms may be overlooked or misunderstood. It is important any new symptoms are assessed in a timely manner and investigated appropriately. It may be good to take a family member or friend to appointments to help with listening and support. Understanding your risk factors, recommended investigations and treatments is beneficial in helping address your risk.

There has been plenty of awareness surrounding the symptoms of a heart attack, but did you know the symptoms of heart attack in women can vary from those experienced by men?

Only one in three women will have 'typical' heart attack symptoms, such as pain in the centre of the chest. Instead, many will have less common symptoms as their first warning sign, including:

• Neck, jaw, shoulder, upper back or abdominal pain
• Shortness of breath with or without chest discomfort
• Pain in one or both arms
• Nausea or vomiting
• Breaking out in a cold sweat
• Light-headedness or dizziness
• Unusual feelings of fatigue
• Heart palpitations

When women do experience chest pain, it is more likely to be described as pressure or tightness, rather than the typical crushing pain.

6. I would never… smoke or vape

This one should be self-explanatory, but it bears repeating that smoking and vaping are strongly linked to cardiovascular disease. Quitting smoking or vaping is one of the best things you can do for your heart health.

Dr Lucy McGrath-Cadell is a researcher and cardiologist with a particular interest in spontaneous coronary artery dissection, inherited vasculopathies, and cardiovascular disease genetics.