According to the Department of Statistics Malaysia, ischaemic heart disease accounted for 13.7% of reported deaths in 2021, making it a significant concern in Malaysia.
Other forms of heart conditions include heart valve disease and heart arrhythmia, contributing to the overall burden of heart diseases in the country.
Despite the gravity of these statistics, a significant number of women continue to experience undertreatment.
What to look out for
The primary manifestation of ischaemic heart disease for both men and women is chest pain.
However, there can be variations in the way heart disease symptoms manifest between genders.
Women may experience a broader spectrum of symptoms, ranging from being asymptomatic to having nonspecific feelings like fatigue, weakness, nausea and breathlessness. They are also more likely to experience discomfort in atypical locations such as the jaw, neck and back.
These differences in symptoms experienced can significantly impact the diagnosis and treatment of heart disease.
According to senior consultant cardiologist and clinical director of women’s health Dr Emily Tan at Institut Jantung Negara (IJN), “Other reasons women are typically underdiagnosed and undertreated is due to how women frequently downplay their symptoms due to a lack of awareness leading to a delayed presentation.
“The historical underrepresentation of women in clinical trials has also led to a limited understanding of the mechanisms and treatment responses for cardiovascular diseases specific to women.”
Know your risk
When considering the factors at play, it's important to recognise that heart disease poses a risk to everyone.
Dr Tan further elaborates, “In the context of women's health, there are specific factors to consider. Pregnancy-related factors such as gestational diabetes, pregnancy-induced hypertension and preterm delivery, along with past breast cancer treatments, particularly radiation to the left chest, can further elevate the likelihood of heart disease.”
Moreover, non-modifiable factors such as genetics, ageing and menopause can influence hormone levels and vascular function, potentially increasing the risk of heart disease. Notably, mood disorders like anxiety and depression which can be more common in women can also aggravate this risk.
Given these insights, the focus should be on managing modifiable risk factors such as sedentary lifestyles, unhealthy eating habits, diabetes, hypertension, high cholesterol and obesity.
Various new advancements in treating heart disease in Malaysia encompasses various pharmacological and device-based therapies to better manage cardiovascular risk factors, heart failure and cardiomyopathies and to improve symptoms and prognosis.
There are also advances in imaging techniques in particular cardiac magnetic resonance imaging to further aid clinical diagnosis and facilitate better understanding of the underlying disease process which in turn helps the clinician in deciding the best appropriate treatment for each individual patient.
Guard your heart
It's important to prioritise heart health at any age through primary prevention.
For individuals above 40, regular check-ups and participation in health screening programmes are recommended to detect risk factors early.
If you have conditions like diabetes, hypertension or known heart disease, following prescribed medications and lifestyle advice while maintaining regular follow-up care is essential to prevent future cardiovascular issues.
For those experiencing symptoms like chest pain, breathlessness or palpitations, seeking prompt medical attention is crucial to rule out cardiovascular disease.
While heart disease continues to be an issue in Malaysia, Dr Tan notes that more people have become aware of the issue, “Generally, I see a healthy trend of increasing awareness amongst people of all ages and genders with regards to heart health, likely attributable to technological advances with easy accessibility to information at the fingertip.
“Nevertheless, it is fairly easy to fall into the trap of misinformation and we need to remind ourselves to seek information only from reliable sources and always cross-check with your doctor when in doubt.”
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