2024-03-21 14:37:00
Music, pink deckchairs and smiling caregivers, for a neglected cause: the “women’s heart bus” begins its 4th season in Cannes across France to invite women to take charge of their specific risks of cardiovascular disease.
Since Wednesday March 21 and until Friday 23, this pink bus has been installed with a tent village on the port of Cannes, a stone’s throw from the Palais des Festivals, in a festive atmosphere but with a somber message.
Cerebrovascular accident (CVA), angina pectoris or myocardial infarction, but also chronic kidney failure, arteriopathy of the lower limbs: cardiovascular diseases attack the brain, the heart, the kidneys, all the arteries… and kill 400 people every day in France. “80% of these deaths could be avoided, provided we know how to assess the risks and recognize the main symptoms. Also provided we adapt our eating habits, practice appropriate physical activity and give up smoking.”
This is the message delivered by health professionals (1) who recently spoke at Sainte Musse hospital during a conference initiated by Professor Gabrielle Sarlon-Bartoli and entitled: “Your heart and arteries need…you!”
One risk in particular has been highlighted: cardiovascular diseases are underdiagnosed in women, while the incidence rate is increasing. This is particularly the case for myocardial infarction, which affects a growing number of women aged 35 to 54 (while the disease is decreasing in men).
Even more worrying: at the same age, mortality after a heart attack is higher in women than in men.
An underestimated risk
Main explanations: “The cardiovascular risk in women is underestimated, screening for risk factors is insufficient and the often atypical symptoms are unknown” summarize Drs Jean-Noël Poggi and Sophia Bensedrine, vascular doctors, respectively president and vice-president of the regional association of vascular medicine, PACA-Corsica (2).
“Ancient knowledge indicated that women were protected from cardiovascular risk by their hormonal status until menopause. Then, their level of risk gradually caught up with the level of male risk. This is no longer the case today: the risk cardiovascular risk for women has increased significantly, particularly with the explosion in their tobacco consumption, says Dr. Poggi. We must also take into account the lack of awareness of a non-specific female symptomatology which we sometimes tend to trivialize.”
An alarming observation
As a result, the findings today are alarming. “With 76,000 deaths per year, cardiovascular diseases represent the leading cause of death among women. They are affected younger and younger, from 45 years old, sometimes younger.“
Women themselves continue to fear breast cancer more than cardiovascular diseases, which are responsible for 200 deaths per day, six times more than breast cancer!
Specific factors not always taken into account
An update on specific risk factors with Dr Bensedrine, who campaigns with the association Agir pour le cœur des femmes (3), whose Bus du Cœur regularly crisscrosses France, with stopovers in the region.
The hormonal status of women is not protective, as ancient knowledge believed. On the contrary, “There are specific hormonal risk factors.”
These include early periods (before age 11), certain gynecological diseases (such as polycystic ovary syndrome or endometriosis), estrogen-progestin contraception, hypertension during pregnancy and gestational diabetes, premature ovarian failure. (before age 40), more than three pregnancies, premature menopause (before age 45), menopausal flushing (more than six per day), breast calcifications and breast cancer treated with chemotherapy/radiotherapy .
Still other factors are insufficiently taken into account: psychosocial stress, intra-family violence, economic and social insecurity, mental load at work and at home, lack of knowledge about healthy living, autoimmune diseases and inflammatory disorders, migraines with aura and environmental risks.
For all these reasons, women themselves sometimes tend to neglect their symptoms and delay their treatment. This is also what a 2022 OpinionWay study, cited during this conference, indicates: “68% of women take care of the health of their family members before worrying about their own and 37% say they lack time to consult a health professional if necessary.”
These specific risk factors are of course in addition to those already known in the general population. They were recalled by Dr Poggi: some of these factors are modifiable: smoking, high blood pressure, high cholesterol, diabetes, obesity, sedentary lifestyle or poor diet, while others are non-modifiable : age, heredity (a first-degree relative concerned).
Other explanations
Beyond risk factors, specific or not, the explosion of cardiovascular diseases among women and their mortality have other explanations: “The lack of prevention and screening, atypical symptoms that are often misleading, a delay in treatment with later calls to the Samu.”
“Cardiovascular disease in women is a particular disease, different from that of men. Revascularization, for example, is more difficult with more fragile arteries.”
The data also shows that women receive little or no rehabilitation. Finally, and this is essential information (to be read elsewhere), the signs of myocardial infarction, one of the most feared cardiovascular diseases, are well known in men but additional symptoms, common in women, are ignored by the general public and sometimes even by caregivers.
Symptoms to know
Discomfort in the arms, shoulders, back, neck or jaw, chest pain and shortness of breath are the most common symptoms of myocardial infarction in men.
Additional symptoms should be taken into account in women, although not specific: sudden dizziness, a feeling of heartburn, nausea or vomiting, cold sweats and unusual fatigue.
“You should be concerned, talk to your doctor or call 15, particularly if you have several risk factors,” experts recommend.
1. Drs Camille Chiabrando and Léonie Grey, the dietitian nutritionist Florence Milhes, the tobacco nurse Isabelle Chantraine and the doctoral student in sport and health Steven Laujac also spoke at this conference. The same conference, hosted by Côte d’Azur caregivers, was organized in Nice on Tuesday January 30.
2. See also the general public website of the French Society of Vascular Medicine: www.macirculation.com
3.
The women’s heart bus will be in Cannes from March 20 to 22 and at Six-Fours from March 27 to 29.
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