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Wrongly considered a male problem, cardiovascular diseases do not spare women. Three key stages of their lives would benefit from better prevention to avoid the worst. Claire Mounier-Véhier, cardiologist at Lille University Hospital, and co-founder of the Agir pour le coeur des femmes foundation, takes stock for Doctissimo.
In 2024, cardiovascular diseases in France will still be the leading cause of death among women, ahead of cancers. However, the latter do not always identify cardiovascular risk as concerning them (the subject seems, wrongly, more masculine) and 55% of them think that it only concerns those over 50. It is not so.
Cardiovascular diseases, leading cause of death in women
If cardiovascular diseases have risen to the top of the list of causes of death among women, it is also because they have not always had the knowledge of the risks surrounding them, nor the reflex to worry about their state. “Fortunately, a change is happening and women are starting to hear that they need to take control of their health” announces Claire Mounier Véhier, cardiologist At CHU Lille, and co-founder of the foundation Act for the hearts of women. This association aims to improve screening for these diseases in women.
And in a woman’s life, there would be three major hormonal periods which require one or more consultations, she explains to us.
When a woman starts contraception
The first phase where cardiovascular risks must be assessed is when the young woman considers contraception. “There is normally a long consultation reimbursed by Health Insurance which is used to identify contraindications to contraception. The doctor must then check blood pressure, cholesterol, blood sugar and see if there is a history, if the young woman has migraine tendencies, obesity, an inflammatory disease, etc. To adapt the contraception which will be the least at risk for her.”
Three months after the first consultation and then every 6 months, it is necessary to check that there is no appearance ofhypertensionmigraine, mood disorders… “Renewing contraception is not a game, it is a period where young girls must be supervised”.
Monitoring which will also have to be renewed around forty, if the woman needs to change contraception.
During a pregnancy plan
The second key phase to watch out for in a woman’s life is pregnancy. “In France, it is well regulated, however we insist on the importance of preconception consultations, since births are occurring later and later (with an average of 35 years). At this age, some women already have risk factors that they are not necessarily aware of.”
Concretely THE Doctors must inquire about their desire for pregnancy at each consultation and if this is the case, initiate a targeted questioning on cardiovascular symptoms. “Many women have heart disease symptoms unknown, of which they are not aware because they attribute them to something else” specifies our expert. The questioning and clinical examination can lead to the prescription of a cardiology consultation.
Prevention is far from being superfluous: the latest maternal mortality report indicates that, still to this day, the leading cause of preventable death is attributed to cardiovascular diseases, often affecting women who have left care, are precarious, or who hide known risks because their desire to become pregnant is too strong. “But this consultation helps balance things out, even a woman with high risks, if well supervised, can be pregnant!”assures the cardiologist.
Post-pregnancy, women who have had hypertension, diabetes or pre-eclampsia must have a postpartum consultation within 6 months for a postpartum assessment.
During premenopause
Around the age of 45, when the cycles go wrong, when the woman gains weight or “gets thicker”, it is also a good idea for the gynecologist or attending physician to have her undergo a metabolic assessment which will assess blood sugar, weight and height. , abdominal circumference and high blood pressure. “High blood pressure is totally neglected in women. At 50, one in two women are hypertensive, but most attribute their symptoms to stress, for example.. Hence the importance of knowing the facts better, of repeating to women that cardiovascular risks concern them and of making them responsible.
“The goal of these various meetings is of course to avoid the first heart attack or the first stroke. But it is also to hammer home to women that it is a question of their health, and that it is time to ‘listen, take the time, give them the necessary knowledge to make them more responsible’ insists Claire Mounier-Véhier. Caught in time, cardiovascular diseases are not always inevitable.
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