12 May 2016 10:42:00

Heart attacks in women: the 'classic' female symptom isn't severe chest pain

One of the big problems with women and heart attack is that they often don't get the 'classic' symptoms of severe tight crushing chest pain.

Overall, heart attack rates among women continue to fall, but there's no room for complacency. In 1995, one in eight women who had a heart attack were under 60 - now that figure is one in four. Read on to stack the odds in your favour.

One of the big problems with women and heart attack is that they often don't get the 'classic' symptoms of severe tight crushing chest pain. Instead, one in three women describe chest 'discomfort'. They're also more likely to get shortness of breath, weakness, unusual tiredness and possible feeling sick, dizziness or upper tummy/back/jaw pain. Chest tightness with dizziness or shortness of breath with exercise could be angina, a warning sign of heart disease - see your doctor!

Many women get similar mild symptoms for days or even weeks before a heart attack. Even if you think it might be a bad bout of indigestion, seek medical help immediately if you get any combination of these symptoms. It's always better to be safe than sorry.

Nobody is at no risk of heart attack, but a host of factors will determine whether your risk is higher or lower than other people's. If you see your doctor, nurse or pharmacist for a free NHS heart health check, they'll be able to calculate your risk of heart attack over the next 10 years. This takes into account several factors such as your age, gender, total and HDL ('good') cholesterol, blood pressure, whether you smoke or have diabetes, whether heart disease runs in your family etc. Your risk of heart attack drops with every year since you stopped smoking - ask your GP or practice nurse for advice.

Until last year, GPs were advised to offer patients regular statin tablets to take if their 10-year risk of heart attack or stroke was more than 20% - in other words, if more than one in 50 people just like them were likely to have a heart attack within the next year. Now the rules have changed and we're offering statins if your risk if more than 10%.

Some of my patients aren't keen to take tablets for life. If there's a real chance they could cut their risk enough with diet and lifestyle, I'll often negotiate a three- to six-month trial period. Then I check their blood pressure and cholesterol again. But it's important to remember that everyone is at some risk of heart attack. So whether you're told you're at 'high risk' or not, healthy lifestyle changes are a good idea.

Clearly it's not possible to change your age (I wish!), but there are lots of risk factors you can influence without medicines. Smoking is the obvious one - quitting for good is the single best present you can give your heart. Changing your eating to a more 'Mediterranean'-style diet can help cut your bad cholesterol, and regular exercise can improve your 'good' cholesterol, which protects you against heart attack and stroke.

Increasing the soluble fibre in your diet (oats, apples, oranges, pears, lentils, aubergines) or taking a food high in plant sterols or stanols (there are lots of fortified options in the supermarket) will also improve your cholesterol. Cutting the salt in your diet to no more than 6 grams a day, like exercise, can improve your blood pressure. But losing weight will improve your blood pressure and cholesterol, as well as reducing your risk of type 2 diabetes. There's no getting away from the fact that having type 2 diabetes increases your risk of heart attack. What's more, among people who have heart attacks, survival rates are lower among people with type 2 diabetes than without, and lowest of all among women with type 2 diabetes.

The good news is that addressing the risk factors for heart attack, like raised blood pressure, cholesterol and glucose, brings even greater benefits if you have diabetes than for other people. If you have type 2 diabetes, it's highly likely your doctor will recommend statin tablets to lower your cholesterol. Your doctor will aim to get your blood pressure below 140/80 if you have type 2 diabetes, or below 130/80 if you have also eye or kidney complications.

With thanks to 'My Weekly' magazine where this article was originally published.

Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.