Victims of modern times

Prejudice is hard. "Contrary to popular belief, which persist even among health professionals, cardiovascular diseases are not the prerogative of men, says Professor Claude Le Feuvre, president of the French Federation of Cardiology. Their impact on women is not only underestimated, but it is also skyrocketing, including among young people. For proof: the percentage of women under 50 hospitalized as a result of a cardiac event has tripled between 1995 and 2010.

Although they fear more the occurrence of breast cancer, cardiac and vascular dysfunctions (myocardial infarction, pulmonary embolism, cerebrovascular accidents, etc.) have now become the leading cause of female mortality. They are indeed responsible for 55% of deaths among women in Europe (43% among men), far ahead of all cancers combined. Before menopause, women feel completely protected by their hormones. Certainly, natural estrogens tend to lower the rate of bad cholesterol and maintain the flexibility of the arteries. But between contraceptives that clog the natural hormonal cycle (pill, vaginal ring ...) and the radical change of lifestyle that has taken place over the last two decades, this physiological protection is less and less effective.

The same stress as men

Work at a steady pace, pressure from the hierarchy, fear of losing one's job, "on-the-go" lunches, alcohol ... "Women are now subjected to the same stress as men and are exposed to the same factors of cardiovascular risks they, says Professor Jean-Jacques Mourad, president of the French Committee against hypertension. Of the 16 million French hypertensives, half are now women. And some are barely over thirty. "

In addition, female smoking has increased considerably. Combined with the taking of a contraceptive pill, it is an explosive mixture, especially beyond 35 years. The duo pill-tobacco indeed increases the risk of hypertension and blood clots that can clog the arteries. And at the approach of menopause, patatras! Cardiovascular fragility is increased tenfold. "In the absence of hormone replacement therapy, the risks become suddenly greater because of the lack of estrogen, weight gain (tenacious at this time), the possible appearance of diabetes, an excess of cholesterol, etc. ", Says Professor Claire Mounier-Vehier, head of the department of vascular medicine and hypertension at Lille Cardiology Hospital.

As most research has been conducted on men, the specific way in which cardiovascular disorders are expressed in women is less well known. Starting with the warning symptoms of a heart attack. "They usually occur in humans as acute pain in the chest, jaw, neck, back, shoulder or left arm, says Professor Mounier-Vehier. In women, the signs may be more diffuse and therefore more difficult to interpret: sometimes chest pain is observed, but often a burning sensation in the pit of the stomach, nausea or vomiting, cold sweats, difficulty to breathe, a feeling of anxiety, an impression of generalized weakness ... "Signals that can easily be confused with indigestion, a peak of stress or flushes of anxiety. Not to mention the machismo of some doctors who consider women more unstable emotionally, even hysterical!

A study by McGill University in Montreal, published last March in the Canadian Medical Association Journal, has shown that in cases of acute coronary syndrome, many US and European hospital emergency physicians make a different initial diagnosis depending on the sex of the patient. patient. They immediately fear infarction for a man. But rather suspect a crisis of anxiety in a young woman. Result: Equivalent gravity, the female population is less well supported medically. It is treated an hour later on average than men, which considerably reduces the chances of recovery. Only 29% of women are, for example, offered an electrocardiogram in the first ten minutes of consultation, against 38% of men. No wonder, under these conditions, that the mortality of women is twice that of men in cases of infarction under 50 years. And when the heart attack occurs over 65 years, the risk of death in the year that follows is greater: 42%, against "only" 24% among these gentlemen. Equivalent severity, the female population is less well supported medically. It is treated an hour later on average than men.

Specific unrecognized disorders

A house of the virtual heart

To assess your individual risk and get personalized support, visit mafedecardio.org. Opened by the French Federation of Cardiology in June, this platform offers tests, tips and practical sheets adapted to each patient profile. It also offers the possibility of a free monthly interactive dialogue with cardiologists on various topics (diabetes, cholesterol, etc.), and to benefit from instant coaching in complete confidentiality. Ideal for informing yourself, taking stock of a treatment and adopting reflexes that will guarantee the lasting health of your heart.

Specific unrecognized disorders

Several feminine specificities explain this incredible injustice. Poorly informed about their cardio-vascular weaknesses, women already tend to react less quickly than men. In case of discomfort, they call for example emergencies thirty minutes later than they, according to a survey of Samu. "Certain anatomical characteristics also play against them, recognizes Professor Mounier-Vehier. The arteries of women are narrower. They close up so faster. And this makes the surgical procedure (angioplasty) inevitably more complicated. "Screening is also difficult in their home to the extent that their main coronary arteries are not necessarily affected, as is often the case in men. In many patients, it is rather an alteration of the microcirculatory heart, related to the obstruction of tiny vessels that feed the heart. During an imaging test (coronography), these tiny anomalies often go unnoticed.

Another factor of disparity: the stress, the overweight, the diabetes and the hypertension make havoc more important with us than with our companions. A Canadian study, from the University of Ontario, clearly showed in August 2012 that excessive work-related stress was twice as bad for a woman as for a man. For a diabetic patient, the risk of heart attack is also twice as high as for a man with diabetes of the same magnitude. As for female obesity, it generates a cardiovascular risk of 64%. It does not exceed 46% for the opposite sex. The same is true for family predispositions: a woman whose first-degree relative (father, mother, brother or sister) has suffered a heart attack is more likely than a man to suffer one in turn. A flagrant inequality, but with which we must nevertheless compose. Because, in terms of health, the policy of the ostrich never pays. "All women at the beginning of menopause, or those with one or more risk factors, should benefit from a cardiovascular checkup," says Professor MounierVehier. The ideal is to ask for an ultrasound of effort, because if the tests carried out on treadmill are relevant to detect a heart fragility in the man, this is unfortunately not always the case in the woman. "