Women And Heart Disease: A Travesty

February is American Heart Month, and one thing that’s being stressed more this year is the fact that many women’s heart problems go undiagnosed, especially if they have atypical symptoms. The American Heart Association just recently came out with revised guidelines of cardiovascular disease prevention for women. The two interesting points they make is that women have a higher proportion of strokes to heart attacks compared with men. The other point they at emphasize is the fact that if  you had a complication during pregnancy, your risk of heart disease later in life is significantly higher.

What was surprising to me is that we have lots of studies showing that most cases of pregnancy-related complications such as preeclampsia and gestational diabetes may be caused by untreated obstructive sleep apnea. Since weight gain is a major risk for sleep apnea, why should pregnant women be excluded from having a sleep-breathing disorder? By definition, pregnancy will cause you to have temporary sleep-breathing problems, whether or not it’s officially obstructive sleep apnea.

The one thing that protects against sleep apnea during pregnancy is the rise in progesterone, which acts as an upper airway muscle stimulant, but this can only help so much. As progesterone drops after delivery, what do you think will happen to women who still have most their pregnancy weight? I’m willing to bet that if you do the same study looking at post-partum complications such as postpartum depression, you’ll see the same increased rate of heart disease later in life.

The shocking thing was that nowhere in these general guidelines do they even mention looking for obstructive sleep apnea. I won’t begin to talk about the link between stroke and sleep apnea–there are just too many studies to mention. I encourage you to take a look at the recommendations of the American Heart Association’s website. Tell me what you think about this glaring omission.

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5 thoughts on “Women And Heart Disease: A Travesty

  1. Change, innovation, and progress is brought on by competition in markets. The AHA is an institution with no direct competition. They are wearing blinders and just keep on plodding down the same path without fear of failure.

    Recognition that sleep apnea is a major cause of heart disease would mean referring patients to doctors specializing in sleep apnea. The staff of the AHA might be of the mind that this would reduce their power and influence.

  2. no, I really think the docs are clueless.
    this really is a nightmare. so few doctors really understand the depth of this problem. Dr. Park, thank you again for your efforts to increase awareness.

  3. Hi Dr. Park,
    Like most heart attack survivors, I was glad to see pregnancy complications finally listed in the new AHA guidelines, but like you, dismayed that sleep breathing disorders did not yet make the official list.

    Just yesterday, another heart attack survivor told me that her cardiologist insists that her sleep apnea (she wears a CPAP now) was not related to her heart attack. And then he told her that pre-eclampsia diagnosed during her first pregnancy was also unrelated to her cardiac event! This lack of awareness from those whose only business is heart disease is distressing.

    FYI, this morning, I posted an article called “Are Your Sleep Problems Linked To Increased Heart Disease Risks?” (featuring your comprehensive reply to my KevinMD.com article on women’s heart attack symptoms). It’s on my blog HEART SISTERS at: http://myheartsisters.org/2011/02/22/sleep-linked-to-heart-disease/

    Regards,
    Carolyn

  4. Carolyn,

    What a great post! Mike Goldman of Sleepguide tried to alert the AHA of these issues about 2 years ago and was essentially told that there’s no conclusive proof that sleep apnea can cause heart disease. Best case scenario, they may admit that sleep apnea is one of many risk factors for heart disease, lumping it in together with poor diet, high cholesterol, high blood pressure, etc.