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Heart Health for Women: Q&A with Dr Daniel Yeo

Heart Health for Women

Questions by the public and answers by Dr Daniel Yeo


Q: How is heart disease different for us women?

A: Women are protected by their natural hormones before menopause, and generally develop heart disease 10 years later than men. In addition, several types of heart disease are more common in women, and even unique to women. For example, microvascular ischaemia, Takotsubo cardiomyopathy (also known as broken heart syndrome), and peri-partum cardiomyopathy.


Q: Does heart disease affect women who are fit?

A: Heart disease can affect fit people, whether men or women. Being physically fit, exercising regularly and eating sensibly reduces the risk of developing heart disease. However, genetic factors play an important role in heart disease. If you have symptoms such as chest pain, breathlessness or giddiness, do see a doctor for advice.


Q: Can you tell us the link between heart disease and stroke?

A: Heart disease and stroke both have similar risk factors. Significant risk factors are having diabetes, high blood pressure and high cholesterol, as well as smoking.


Q: Sometimes I feel like the left side of my chest has terrible cramps. Is this a sign of an impending heart attack?

A: I hope it's not due to a heart attack! Of course, we should treat any chest pain seriously to work out what is causing it. It's important to make sure it's not a heart attack because a heart attack is potentially life-threatening. Even when an individual survives a heart attack, the heart is likely to be permanently weakened.

The other possible reasons for the chest pain could be a muscle strain, bruised rib or lung problem. If the symptoms are severe or persistent, please see a doctor.


Q: Are there ways to remove bad cholesterol permanently from the body?

A: Cholesterol can be removed from the body, but there is continuous movement of cholesterol in and out of the body and bloodstream. If cholesterol is deposited in the blood vessels, it can cause a narrowing of the vessels. Standard doses of medication can stabilise the cholesterol deposit and prevent it from increasing in size, but cannot significantly reduce it.


Q: What are simple screening tests that I can take to know my heart health?

A: The basic tests to check the heart are blood tests (looking at the cholesterol and sugar levels), an electrocardiogram or ECG (electrical picture of the heart), an echocardiogram (ultrasound of the heart), and a treadmill stress test. Do check with your doctor whether these tests are suitable or necessary for you.


Q: What can I do to lower the risks of getting heart disease?

A: Eating healthily, exercising regularly, and going for regular health check-ups are the key to reducing your risk of heart disease. If you have a chronic condition such as diabetes, high blood pressure or high cholesterol, you should ensure that these are under good control.


Q: Is aspirin good for our heart? Can it help prevent heart disease?

A: Aspirin has been shown to reduce the damage that occurs during a heart attack. When it is taken as a preventive measure, it can reduce the chance of a heart attack happening. Do check with your doctor whether aspirin is suitable for you before starting it. Any medication has the potential to cause side effects. If you are on medication, please go for a regular follow-up with your doctor.


Q: Do heart treatment options differ between men and women?

A: Usually the treatment of heart conditions is similar for men and women. However, heart conditions may develop at different rates for the different genders.


Q: What is broken heart syndrome? Is it serious?

A: Broken heart syndrome occurs when a person experiences a significantly stressful event, resulting in a surge of stress hormones in the blood circulation, which can cause the heart to suddenly fail. It was first described by a group of Japanese doctors, hence the name Takotsubo cardiomyopathy, as the shape of the heart while it contracts mimics the shape of an octopus pot (‘Takotsubo’). It is also known as stress cardiomyopathy.


Q: Are heart problems genetic (ie. do they run in the family)?

A: Research shows that there is a strong genetic basis to many diseases, including heart disease. That is why a family history of early-onset heart attack is a risk factor for heart disease. However, the relationship between family history and heart disease is complex. Not everyone will develop heart disease.

A person who has a few siblings afflicted by coronary artery disease may have completely normal coronary arteries. There are many factors involved in the development of heart disease – some known, some unknown. Some people are just ‘lucky’, and this may be down to unknown factors which have yet to be discovered.


Q: What is the ideal ratio for HDL-cholesterol to be defined as a safe range?

A: The total cholesterol to HDL ratio should be less than 4.5. HDL cholesterol is the so-called ‘good’ cholesterol – the more of it you have, the more protection you have against heart disease.


Information contributed by Dr Daniel Yeo, cardiologist at Gleneagles Hospital, Singapore.

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