Dr. Calls More Protection For Women’s Hearts!

It is often said that women have a big heart – but it is smaller than men’s. But it is no less vulnerable, on the contrary. Cardiologist Dr. Catharina Hamm explains how we can protect our heart health.

But prevention is not sexy, or, as the doctor put it in an interview with BRIGITTE: “Nobody is thankful for the disaster that didn’t happen” – in other words, our health system and often our own attitudes are too focused on repair and healing. It would be much better not to get sick in the first place. But we have to do something about it ourselves.

“Heart disease does not develop overnight, but over 20 or 30 years,” says Hamm. The risk is made up of 20 percent genetics, 30 percent environment, such as social status or access to medical care, and 50 percent lifestyle. The good news from these figures is that we can actively influence lifestyle factors. That gives us hope!

Heart-healthy lifestyle: The doctor shows how it’s done

The 43-year-old sets a good example herself: “I eat my overnight oats with fresh berries every morning. Because they taste good and because oatmeal contains heart-healthy beta-glucans. I also enjoy my coffee in the morning in peace. Coffee in moderation is better for the heart than thinking too much.”

The heart expert also makes sure she gets enough exercise in her everyday life. “If I don’t manage to do any exercise, I try to get my 10,000 steps in. I do strength training twice a week, no matter where I am.”

Because she knows how much stress affects the heart and how important relaxation is, the 43-year-old tries to get as much sleep as she can for her 7-8 hours a night and often treats herself to a social media detox. “For example, I can switch off by jogging in the woods and clear my head. It’s important to know what’s good for you – for some people, relaxation means baking a cake or knitting. For me, it’s definitely exercise in the fresh air.”

Important to know: The 5 biggest risk factors for the heart

overweight

This is not about a few extra pounds on the ribs. Obesity officially begins at a BMI of 30, but this unit is very imprecise (the Body Roundness Index is being discussed as an alternative) when it comes to assessing the actual risk. Above all, it depends on the proportion of fat mass and the distribution of fat in the body, because belly fat in particular leads to metabolic disorders because it produces numerous disease-causing messenger substances and inflammatory factors. “Inflammation has much more to do with the heart than most people think. Arteriosclerosis in the vessels is an inflammatory disease,” explains Dr. Catharina Hamm.

high blood pressure

In the early stages of high blood pressure, the “lady killer”, as Dr. Hamm calls it in her book, is barely noticeable or not noticeable at all. In the long run, however, it overstrains the heart muscle because it has to work against the increased resistance with each heartbeat. The muscle thickens and then needs more and more oxygen, which it does not get. High blood pressure leads to vascular damage throughout the body. In addition to the heart, the kidneys, eyes and brain are also at risk.

Elevated cholesterol levels

Cholesterol consists of fat molecules and vital building blocks for cells and hormones. So-called lipoproteins are responsible for transporting them in the body. LDL cholesterol (low density lipoprotein) transports fat molecules to the cells, HDL cholesterol (high density lipoprotein) brings excess fat back to the liver, where it is broken down. If the ratio is not right, i.e. LDL, the “bad” cholesterol, predominates, plaques form and arteriosclerosis develops.

diabetes

“Sugar eats holes in the teeth and also in the endothelium, the inner protective layer of the blood vessels,” explains Dr. Hamm. “Cholesterol can penetrate and deposit itself more easily through these holes.” Diabetes mellitus damages women’s hearts even more than men’s. On the one hand, women are sicker when they get diabetes, and on the other hand, they have prediabetes for longer, the early stage – and this is also harmful to the blood vessels. The expert therefore advises: “For the sake of your heart, regulate your sugar levels well.”

Smoke

Tobacco smoke contains many chemical pollutants that are not only carcinogenic, but also increase blood pressure, constrict blood vessels and promote deposits. This massively increases the risk of heart attack. Especially in women. Compared to men, female smokers have a 25 percent higher risk of harmful deposits in the coronary arteries. It is never too late to quit. After a year without cigarettes, the risk is already halved. But it is only after 15 years of not smoking that it is the same as that of non-smokers.

Watch out! Women’s hearts seem to fly under the radar

Dr. Catharina Hamm, who is also an expert in gender medicine, knows from her practice numerous cases in which heart problems in women were not recognized and treated or were treated too late because the symptoms were either not taken seriously or misinterpreted.

The figures show that women do not have a heart attack more often than men, but they die from them more often. “The so-called 30-day mortality rate is sometimes twice as high as in men,” says Dr. Hamm. Although the mortality rate is falling overall, analyses show that this rate remains high in the 45 to 60-year-old age group. On the one hand, because the risk factors of diabetes and obesity increase so much in women during these years. But also because this is the age at which everyone misjudges the risk – both the women themselves and the medical staff. And then valuable time is lost. “The delay in treatment is the problem,” confirms the doctor.

Another problem: The symptoms of cardiac arrhythmia are often confused with panic attacks. Especially in younger women. “I’m thinking of a patient who was given psychotropic drugs for three years and had to put up with severe side effects,” says Dr. Hamm. Until this woman bought a smartwatch and noticed almost by chance that her pulse rate was increasing extremely high in fits and starts. So it was something organic after all. “We cauterized the corresponding part of the heart that was causing the cardiac arrhythmia and the ‘panic attacks’, which weren’t actually panic attacks, stopped immediately. So she didn’t need the psychotropic drugs at all.”

Even when women are being treated for a heart condition, they are significantly less likely to attend rehabilitation measures. This is because they are offered them less often and, if they do go, because they can think of all sorts of reasons why they don’t want to go. For example, because they don’t want to or can’t leave their husband or relatives they need to care for alone. But when they are in rehabilitation, they often feel very uncomfortable there and end their stay early. “I had a patient who was 44 and had a serious heart attack. In rehabilitation, she was the only young woman among a whole bunch of old men with whom she had hardly any contact,” recalls Dr. Catharina Hamm. We actually need our own women’s heart rehabilitation facilities. Because we know that rehabilitation has a huge influence on the further course of the disease. I would like women to take advantage of this more often.”

Why estrogen plays such a big role

The female sex hormone estrogen has an anti-inflammatory effect and acts like a protective shield for the blood vessels. When menopause begins, estrogen production naturally decreases until the ovaries no longer produce any. This turns the tables because the important heart protection is missing. To make matters worse, the proportion of visceral fat increases postmenopausally because muscle mass is lost. “This visceral fat is pro-inflammatory,” explains the doctor. You can find out more about this in the article Menopause and belly fat .

In women, the LDL level increases by up to 30 percent after menopause. This is because estrogen helps to form the LDL receptors in the liver. This is how cholesterol is transported into the cell. The fewer there are, the less can be transported in and more remains in the blood. In addition, we no longer use the LDL to produce estrogen – cholesterol is a precursor to estrogen.

Blood pressure also changes with the menopause. Women tend to have low blood pressure at a younger age. “Postmenopausal, almost 50 percent of women have high blood pressure that requires treatment,” explains Dr. Hamm. It is important to know that the risk of heart attack in women begins at lower blood pressure levels than in men. “We should therefore actually treat high blood pressure in women even earlier. Not only when systolic values ​​are 140 mmHg or higher, but I would prefer to keep them at 120/70 mmHg for as long as possible,” says the cardiologist. Because if a woman’s heart has been used to a fairly low blood pressure for decades, then even a value of 140 can be critical, simply because the increase is enormous.

One event that affects 90 percent of postmenopausal women is broken heart syndrome, or Tako-Tsubo syndrome. This is a temporary heart failure that can occur after a strong emotional event. The stress hormones released in large quantities then dock in certain regions of the heart. This paralyzes or deforms the left ventricle. It then looks like a Japanese octopus trap called Tako Tsubo. Here, too, there is a connection with the loss of estrogen, which protects the heart from a stress attack.

Know your personal risk, recognize the red flags

What we often fail to realize is that pregnancy is an enormous strain on the entire organism. Gestational diabetes and gestational high blood pressure are risk factors for later heart disease that hardly anyone considers. “Even if they go away after pregnancy, they leave behind damage to the blood vessels that only becomes visible years later,” says Dr. Hamm. “Pregnancy can also fuel existing predispositions to vascular damage because the cardiovascular system is really stressed for the first time, also due to the additional blood volume that women then have in them,” adds the expert.

Unfortunately, there is a lack of long-term follow-up care in such cases, and this also applies to childhood cancer. In this case, close-meshed preventive care for the heart would be necessary in order to be able to contain the long-term effects of the disease or the treatment.

In general, it is a good idea to know your risks early on, i.e. at a young age, so that you can always make adjustments. This applies to previous illnesses, but also the risk profile in the family, especially if there are heart attacks in first-degree relatives, i.e. mother or father.

Above all, it is important to take complaints such as severe pain or shortness of breath that occur suddenly and at rest seriously and to seek medical attention quickly. Possible symptoms of a heart attack in women are:

• Pain in the back, jaw, neck
• shortness of breath with little exertion
• feeling of anxiety and fear
• pain in the upper abdomen
• chest and arm pain
• fatigue and dizziness
• nausea, vomiting
• cold sweats, pale skin

Women, take good care of yourselves!

Avoiding nicotine and alcohol, eating a healthy, balanced diet and exercising regularly – in other words, a healthy lifestyle – can counteract obesity, diabetes, high blood pressure and high blood fat levels, and thus keep the general risk factors under control. If we follow these basics, we will already have done a lot for heart health.

However, Dr. Catharina Hamm believes that women still pay too little attention to their pulse. She therefore recommends getting into the habit of measuring your pulse: “Measuring your pulse is the simplest form of biohacking.” According to the German Heart Foundation, the radial artery on the inside of the wrist is particularly suitable for this: simply place two or three fingers on the inside of the wrist below the thumb and count the beats for 30 seconds. The value multiplied by two gives you your pulse per minute.

Women’s resting heart rate is generally a little higher than men’s because we transport less blood per heartbeat. A value between 60 and 90 per minute is normal, but it would be good if it was between 60 and 70. “A lower resting heart rate is better because every beat means a loss of oxygen. The less often it has to beat, the more energy the heart saves,” explains the specialist.

What else we can do: Go to your GP’s office for regular check-ups. From the age of 35, the health insurance company will pay for this every three years if there are no risk factors. And if something is discovered, high blood fat levels can be treated with statins, for example. The important thing is not to ignore the warning signs.