Cardiac Prevention in Women. Interview with Dr. Patrizia Romano.
Cardiovascular diseases are the leading cause of death worldwide, affecting women as well, especially after the age of 65. A significant percentage of these deaths could be avoided adopting proper preventive measures: but how can we best protect women's heart health? Dr. Patrizia Romano, a cardiologist and expert in cardiovascular prevention for women, will guide us through this journey. Among the specialists available for free consults and EKG during the Cardiovascular Prevention Open Day on 22 February 2025, Dr. Romano will offer her expertise, providing valuable advice on how to prevent and manage cardiovascular risks.
Dr. Romano, what are the main factors that expose women to higher risks of developing a cardiovascular disease compared to men?
Women can be vulnerable to cardiovascular diseases due to a combination of factors, the primary one being hormonal changes related to menopause, which negatively affect cardiovascular health. These changes add to other risk factors such as increased cholesterol and hypertension, particularly common in the post-menopausal phase. In addition, women may experience the onset of an ischemic heart disease due to causes other than atherosclerotic disease, such as coronary artery wall dissection. Finally, women are more likely than men to experience cerebrovascular events.
Can you mention some of the differences in terms of symptoms?
Heart attacks are often associated with classic symptoms, like chest pain or discomfort in the left arm, but in women symptoms can be different and less obvious. Women may experience atypical symptoms that are harder to interpret. These signs include shortness of breath, unusual fatigue, nausea, epigastric pain, pain in the jaw, neck, throat, or back. These symptoms, often underestimated, require special attention for an early and timely diagnosis.
What advice would you give when discussing female cardiovascular prevention?
Cardiovascular prevention in women must take into account differences in symptoms, the various pathophysiological mechanisms of cardiovascular diseases, and the different stages of a woman’s life, such as pregnancy and menopause. Women are also affected by the incidence of breast cancer, and in these cases, the risk of myocardial damage caused by chemotherapy and radiotherapy should be considered. In such cases, a cardiological evaluation will allow for early assessment of potential damage and to start a cardioprotective therapy to prevent progression to heart failure. Women also tend to pay less attention to their health: constantly focused on caring for family members, they tend to take less care of themselves, to underestimate symptoms, and delay medical advice. This delays diagnosis and treatment, the timeliness of which is essential for its effectiveness. Raising awareness among women on primary and secondary prevention and being attentive to signs from their bodies can significantly improve the prognosis. Regular, targeted screenings are important to assess cardiovascular risk, determine necessary tests, and set the appropriate timing for them. Screening sessions are also useful for providing information about a healthy lifestyle, a correct diet, and the importance of regular physical activity.
What further advice would you give to women?
I would recommend quitting smoking, moderating alcohol consumption, since it is less tolerated by women than men, and regularly monitor blood pressure, blood sugar levels, and LDL cholesterol, and also to adopt an active lifestyle, with at least three hours of aerobic exercise every week.