A woman's heart works really differently than a man's heart. That's why in this file:everything you need to know about your heart, how to keep it in top condition and which misunderstandings should be cleared up.
heart problems. It may sound like a far-from-your-bed show. Something that happens to your elderly neighbor or obese uncle. Not as an issue that fresh, fit women have to deal with. So why bother with it at all? Think again, says cardiologist Janneke Wittekoek, who specializes in the female heart and founder of HeartLife Clinics. For fifteen years she has been calling for more attention to be paid to cardiovascular disease in women, because it is the number one cause of death among women worldwide.
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“More women than men die from it in the Netherlands, 55 every day. So something is not going well at all,” said Wittekoek. At the same time, it is mainly the man's heart that is in the spotlight. Somewhat logical, because a heart attack was a real men's disease for a long time. Wittekoek:“In the last century it was the men who were most at risk of cardiovascular disease, because they were the ones who smoked, had stressful jobs and started exercising much less after obtaining their driver's license. For example, it could happen that mainly men were affected, but women have made a real catch up as a result of the emancipation waves. They also started smoking, got similarly stressful jobs and got into the car every day instead of walking or cycling.” These risk factors partly explain why more and more women are dying from the effects of cardiovascular disease.
“The alarm bells only went off when the death rate from cardiovascular disease in women continued to rise in the 1990s, while a downward trend was visible in men due to improved care and medicine,” says Wittekoek. “How could that be? From that moment on, studies have been started into the complaints patterns of women with cardiovascular diseases. It became clear for the first time that these patterns are very different in women than in men.”
Anatomically, a woman's heart is the same as a man's heart. It also has two atria, two chambers, and four heart valves. But heart complaints manifest themselves in a very different way in women than in men, so the symptoms are often missed. “In men, a pressing, cramping feeling in the chest is the main complaint,” says Wittekoek. “Women are more likely to have pain between the shoulder blades. It seems that their bra is too tight, they have the feeling that they can't breathe, they are short of breath and often very tired. Doctors mistakenly mistake this for premenstrual or menopausal symptoms.”
But even when a search is made for traces of cardiovascular disease, often nothing is found. Wittekoek:“Studies show that women who have only a little atherosclerosis already suffer from a cramping of the smaller blood vessels. As a result, they experience severe complaints, but these disappear as soon as they receive medicines in the ambulance that open the blood vessels wide. In the hospital there seems to be nothing wrong:EKGs show no abnormalities, the blood vessels are okay. Women are always sent home with the message to slow down, but a few weeks later they are back.”
Compare it to migraine, which is also a condition that is difficult to catch. “It is incredibly important that complaints are recognized in time and treated properly right away,” says Wittekoek. “Almost all of our cardiology knowledge and associated protocols and guidelines are based on studies on male subjects. But the treatment that works for men often has the opposite effect for women. For example, women have more side effects and the doses are often much too high, making them sick and stopping sooner. But in the meantime they do run a high risk of a heart attack.”
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Janneke Wittekoek has made it her mission to identify, recognize and remedy cardiovascular diseases in women in good time. “The women who knock on the door of Heartlife Klinieken are often regular customers of the GP and the First Aid. They feel misunderstood and, in the worst cases, arrive with antidepressants and antacids. They are often too heavy, because they no longer dare to exercise due to the cramps. They feel anxious, are deeply unhappy and do not feel comfortable in their bodies. My goal is to break the negative spiral they have fallen into, so that they can return to fitness.”
Most women who come to HeartLife suffer from a spasm of the smaller blood vessels. “You have to see this cramping as a serious disturbance of the vascular function,” explains Wittekoek. “This is often a result of a combination of risk factors, such as high blood pressure, high cholesterol, a lot of stress and therefore stress hormones and sometimes also diabetes. The first step within HeartLife Clinics is to manage those risk factors. This happens as much as possible through lifestyle changes:less stress, more exercise, healthier food. But sometimes we also use medicines to get the risk factors under control.”
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The result:a whole new life. Wittekoek:“That is really what we see happening here. That is why I insist on better information about women's hearts. The sooner you catch it, the better you can contain the risk factors. Know your numbers:your blood pressure, your cholesterol, your BMI. Buy a blood pressure monitor or visit your doctor for a check-up. I sometimes say that you are lucky if you get complaints that are recognized. If you are unlucky, the first manifestation of cardiovascular disease is a fatal heart attack that you cannot remember. Take responsibility yourself and immediately ring the bell in the event of complaints. This is the only way we can move forward.”
Source:Santé June 2019, text Fleur Baxmeier
