Why do women over 40 need to pay closer attention to heart and metabolic health?

Heart disease is the leading cause of death for women in India surpassing all types of cancer and showing a significant rise in prevalence particularly at younger ages. Heart attack symptoms can be different and more subtle in women than in men, hence it is frequently misdiagnosed and under recognized.While many correlate heart disease with older men, the fact is women of all ages are vulnerable. The risk significantly increases after menopause but younger women are not immune. Lifestyle factors, pregnancy complications and genetic predisposition all contribute to the development of heart condition.The size and structure of a woman's heart is different from a man's heart. Coronary microvascular disease, a disease in the smaller arteries of the heart is more common in women- is hard to diagnose, which can cause delay in treatment.For women over 40, paying close attention to heart and metabolic health is crucial due to hormonal changes that accompany perimenopause and menopause. The decline of estrogen removes a protective effect on the cardiovascular system which can significantly increase the risk of heart disease. Hence, the 40's a critical period for proactive health management to ensure long-term well-being. The Hormonal shifts during perimenopause that is the natural decline in estrogen triggers a cascade of physiological changes that increases the heart disease risk.Cholesterol changes: the loss of estrogen can increase bad cholesterol LDL and Triglycerides while decreasing good cholesterol HDL, leading to higher risk of plaque buildup in the arteries { atherosclerosis }.Stiffening arteries: Estrogen helps in keeping blood vessels relaxed and flexible. Its decrease can lead to stiffer arteries which increases blood pressure and strains the heart.Weight gain and fat redistribution: A slowing metabolism combined with hormonal changes leads to weight gain around the abdomen. The visceral fat is hazardous releasing inflammatory chemicals that damage the cardiovascular system.The hormonal shifts impact mental health and therapy increasing the likelihood of conditions that raise heart disease risk.The metabolic syndrome comprises high blood pressure, high blood sugar, high cholesterol and excess belly fat, 2 to 3 times more common in postmenopausal than premenopausal.Increased diabetes risk.Increased insulin sensitivity - makes it harder for the body to regulate blood sugar effectively.Increased energy expenditure - the decrease in estrogen can lead to lower metabolic rate and reduced energy expenditure thereby resulting in weight and fat gain with no change in food intake. The symptoms are different and more subtle in womenPain in neck, jaw or backDizziness or light headednessNausea or indigestionShortness of breathUnexplained or unusual fatigueWomen over 40 should be proactive about monitoring their health. The American Heart Association ( AHA ) recommends " Life's essential 8 " for better Cardiovascular healthEating a healthy dietMaintaining physical activityManaging weightAdequate sleepControl of blood pressure, blood sugar and cholesterol .Avoiding smoking and alcohol .Managing stress - chronic stress can negatively affect the heart.Dr. Dhinesh David, Consultant, Department of Cardiology, KIMSHEALTH Trivandrum