Women’s Heart Health

Cardiovascular disease (CVD) is the No. 1 killer of women worldwide, accounting for the deaths of 8.6 million women each year – an average of one per minute. In Singapore, CVD causes about 1 in 3 female deaths every year.

Women take on multiple roles in life – managing a household, being the gatekeepers of their family’s health and striving for career opportunities while addressing the physical and emotional challenges from pregnancy to menopause. More often than not, as women balance the competing demands of family and work, they lose sight of their health and well-being. Many women are also unaware that they are as vulnerable to CVD as men.

Take the first step against CVD by learning the common risk factors and recognising the signs and symptoms.

Non-Modifiable Risk Factors:

  • Age
  • Gender
  • Family History

While we cannot reduce the risk of CVD arising from non-modifiable risk factors, it is important for us to be informed about these risk factors and ascertain whether we are at high risk of developing heart disease.

However, the good news is, you can reduce modifiable risk factors by changing personal habits and practices – it is never too late to start adopting heart-healthy habits!

Modifiable Risk Factors:

  • High blood cholesterol
  • Both men and women are at a high risk of heart disease due to high cholesterol arising from unhealthy lifestyle habits.

    But there is a key difference — related to hormones — that women should be aware of. Women generally have higher levels of HDL (good) cholesterol than men, due to the female sex hormone, oestrogen. When women undergo menopause around 50 years old and oestrogen level starts to fall, cholesterol may begin to build up on artery walls. A build-up of plaque in vessels can increase the risk of heart disease or stroke.

  • High blood pressure
  • According to the National Population Health Survey 2019, 14.5% of women aged 18 to 74 in Singapore are reported to have hypertension, with the prevalence increasing with age.

    Your risk of high blood pressure is higher if you:

    • Have a family history of high blood pressure
    • Exceed healthy weight range by 9kg (20 pounds or more)
    • Have reached menopause
    • Consume alcohol excessively
    • Smoke
    • Have a stressful lifestyle
    • Have gestational hypertension, especially in the last trimester of pregnancy

    Go for regular health screenings and keep track of your blood pressure at home by using a Blood Pressure monitor.

  • Diabetes
  • Women with diabetes have a higher risk of heart disease and other complications compared to men with diabetes.

    Overweight, obesity and physical inactivity are contributing factors of diabetes. In addition, women who had gestation diabetes during pregnancy are also at risk of type 2 diabetes later in life.

  • Physical inactivity
  • According to the National Population Health Survey 2020, only 30.7% of women between 18 to 74 years old participate in regular exercise. Reasons for low levels of participation among women often include: a lack of time due to work and child commitments, perception of doing adequate physical activity from undertaking housework and a lack of interest.

    Physical inactivity can lead to overweight or obesity, high blood pressure, high cholesterol, diabetes, which are the other risk factors for heart disease.

  • Overweight/Obese
  • The National Population Health Survey 2020 has found that 33.6% of female adults in Singapore are overweight or obese.

    Obesity increases the risk of chronic diseases such as diabetes, hypertension and high cholesterol, cardiovascular diseases and certain cancers.

    Find out your BMI and take active steps to manage your weight.

  • Smoking
  • In general, smoking increases the risk of heart disease and stroke by 2 to 4 times. Women who smoke have a 25% higher risk of developing heart disease as compared to men who smoke.

    Passive smokers face the same health risk as smokers – approximately twice the risk of heart attack and are more than twice as likely to meet with sudden cardiac death.

    Although smoking causes a great deal of damage, quitting smoking can effectively reduce your cardiovascular risk by 50% within one year. Within 15 years, your risk will be reduced to nearly that of a non-smoker.

    It is never too late to take the first step to quit smoking and take charge of your heart health.

  • Stress
  • Even with supportive spouses, many women still struggle with balancing work and home tasks like helping the kids with homework and cleaning up household messes while scrambling to make dinner after a 10-hour workday filled with deadlines. According to studies, all these stressors could put women at higher risk of a stroke, developing heart disease and other chronic conditions than men.

    It is unclear how job strain causes cardiac problems, but the stress may aggravate inflammation in coronary arteries, leading to blood clots that can trigger a heart attack. Stress also makes it harder to practice heart-healthy habits, such as exercise, a good diet, not smoking, and adequate sleep.

    According to the American Heart Association, women who reported high levels of work-related stress were 38% more likely to suffer a cardiovascular event than co-workers with low levels of stress . But it is hard to tell what proportion of heart attack risk is due to psychological stress compared to other poor lifestyle habits that arise from stress, e.g. smoking or lack of exercise.

    Watch our Zoom Webinar on “Emotional Stress and Heart Disease in Women by Dr Goh Ping Ping and Ms Janice Chen.