Despite Pandemic, Cardiometabolic Diseases Should Remain Top-Of-Mind for Women

Author: Anita D. Szady, MD, FACC, Cardiologist & Linda Gaudiani, MD FACE FACP, Endocrinologist, MarinHealth Medical Network

Given the immense media attention surrounding Coronavirus (COVID-19), other health issues may not be getting the attention they deserve. One such issue affecting women is the combined risk of heart disease and diabetes, or cardiometabolic disease.

Once considered a disease that affects mainly men, heart disease is actually the leading cause of death for women in the United States. The stunning facts about heart disease and diabetes are well known after many years of study, yet this data remains largely underappreciated. The Centers for Disease Control and Prevention (CDC) report that only about half of women (56%) are aware that heart disease is their number one killer.

This is dangerous because unlike COVID-19, prevention and treatment strategies for cardiometabolic disease are well known and within every woman’s reach.

Overlooked information regarding cardiometabolic risk in women include:

  • In 2017, 299,578 women in the United States died from heart disease. This is 1 in 5 women!
  • In 2017, heart disease accounted for 21.8% of all deaths in women, while cancer accounted for 20.8%.
  • Seven times more women die from heart disease vs breast cancer annually. 268,600 women in the US were diagnosed with breast cancer in 2019, and 41,760 died from breast cancer, while 299,578 died from heart disease. (AHA: goredforwomen.org; 2019).
  • Between 2013-2016, 44.7% of females age 20 and older had some form of cardiovascular disease.

Heart disease presents in all ages and includes hypertension, heart attack, stroke, coronary artery disease, peripheral artery disease, and aneurysms. Less known risk factors for heart disease include pre-eclampsia and gestational diabetes.

We have heard them before, but the leading risk factors for heart disease in women are worth another review: hypertension, smoking, high cholesterol, family history, obesity, physical inactivity, stress, and diabetes.

Another underappreciated fact is that pre-diabetes and diabetes now affect nearly half of U.S. adults and as many as a quarter of U.S. children and adolescents! This last risk factor is especially important because it suggests that metabolic disease is not getting better; it’s getting more prevalent and more serious at younger and younger ages.

Perhaps related to women’s hormonal fluctuations throughout their lives, their complex societal roles, the dynamics of their reproductive lives and the huge hormonal changes after menopause, women have just as much diabetes as men. Diabetes is closely related to obesity and overweight conditions, inactivity, and stress, all of which may uniquely affect women during the course of their lives.

Researchers are now focusing on cardiometabolic disease in women for good reason:

  • Cardiometabolic disease and its complications currently account for more than 50% of deaths in women.
  • Diabetes is considered a “coronary artery disease risk equivalent,” meaning that having diabetes is an equal risk factor as having already suffered a heart attack!
  • Adults with diabetes are 2-4 times more likely to die from heart disease than adults without diabetes.
  • At least 68% of people age 65 or older with diabetes die from some form of heart disease; 16% die of stroke.
  • More than half of patients in Coronary Care Units have diabetes or stress related high blood sugars conditions.
  • Prediabetes can be reversed with intensive lifetime modifications and diabetes can be prevented.

So how can women address the risks of developing cardiometabolic diseases? The good news is that women can prevent much of this disease burden by modifying key factors such as:

  • Controlling high blood pressure and high cholesterol
  • Preventing/controlling diabetes through intensive lifestyle improvements, monitoring, education, and possibly medications
  • Recognizing metabolic syndrome (a combination of high blood pressure;
    low HLD levels; high triglyceride levels; high blood sugar levels; large waist circumference/central obesity and sometimes gout)
  • Weight management and regular exercise
  • Stopping smoking
  • Eating a healthy diet, moderate in calories, salt and cholesterol/saturated fats
  • Stress reduction

Clearly our risks for being affected by cardiometabolic diseases should not be ignored. If you did not have a chance to attend the Marin Healthcare District’s recent Community Forum on Heart Disease and Cardiometabolic Health in Women, we invite you to learn more about women and heart disease during this time of reduced social activity, and to assess your particular risks and the preventive measures you can take starting now.

You can find a video of our presentation, here.