Diastolic Heart Failure
"Statistically, the prevalence of diastolic heart failure, otherwise known as heart failure with maintained ejection fraction (the amount of blood being squeezed out of the heart used to determine how well the heart is pumping), is higher in women than men. This is especially true in woman 60 and above, and the susceptibility of women to this condition can increase exponentially compared to men," said Dr. Lily Zhang, assistant professor of medicine at BCM. "In those who have a normal ejection fraction – the heart may appear to have normal pumping function, but chamber relaxation is the problem. If the heart doesn’t relax well, it cannot fill well, therefore it cannot function efficiently."
As a result, pressure and fluid back up in the lungs and venous system, causing common symptoms of heart failure, such as difficulty breathing, marked exercise intolerance, and swelling, which are virtually indistinguishable from heart failure with reduced ejection fraction.
Reasons for the increased prevalence of diastolic heart failure in older women are unclear but researchers are studying the issue.
This heart condition is rarely hereditary, but instead is predominantly brought on by lifestyle choices.
"Hypertension is likely the most important risk," said Zhang, who is also a physician with The Women's Center for Comprehensive Care at BCM. "Many times people think because they are in their 30s to 40s, they are too young to worry about high blood pressure. By the time they are diagnosed, it may have already caused extensive damage to the heart."
Other major associated risk factors are obesity, diabetes, coronary artery disease and kidney disease.
Since these symptoms can be confused for other ailments, Zhang said monitoring your blood pressure through regular doctor visits and emphasis on prevention options, such as maintenance of normal body weight, regular exercise and healthy diet, is important.
"Peripartum cardiomyopathy occurs in women who are in their last month of pregnancy and up to five months after giving birth," said Zhang. "This condition can affect women even if they had a healthy heart before pregnancy."
The exact cause is unknown but the condition weakens the heart and can cause heart failure. The symptoms include shortness of breath with minimal activity or while lying down, swelling of the legs, or generalized weakness. Many times, pregnant women or those who have just given birth think these symptoms are normal.
Zhang said it is important to let your doctor know about these symptoms so he or she can properly assess you. The key to recovery is early diagnosis.
Many risk factors that lead to the development of coronary artery disease can also affect heart muscle and the circulatory system. These factors can cause heart failure to occur prematurely, with or without having already suffered a heart attack, said Zhang.
Conditions such as high blood pressure, obesity and smoking can all damage the heart. She said making lifestyle changes can lower the likelihood of having heart problems in those with or without genetic predisposition.
"Knowing your family history as well as talking to your doctor about health risks is essential to heart and overall health. Early prevention is key," Zhang said.