For too long, heart disease has been painted as a man’s issue. What comes to mind is the typical image of a burly businessman clutching his chest in agony. In truth, the reality is far from such Hollywood depictions. Heart disease is the leading cause of death for women in Singapore, claiming more lives than breast cancer. Yet only a fraction of women are aware of this startling fact.

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Dr Sim Hui Wen, Consultant, Women’s Heart Health Programme, Department of Cardiology, National University Heart Centre, Singapore (NUHCS), sheds light on this critical issue, debunking myths and encouraging women to take charge of their heart health. “There’s a historical perception of heart disease as a man’s disease,” she says. “Public health campaigns have been successful in promoting breast cancer awareness, yet it is also important to recognise the significant risk heart disease poses to women.”

Women often put other priorities above their own well-being, neglecting symptoms and delaying screenings. This, coupled with limited health literacy in some communities, creates a dangerous silence around women’s heart health.

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One of the biggest misconceptions is that heart attack symptoms are universal. “Women are more likely to experience atypical symptoms,” says Dr Sim. Besides the classic chest pain characterised by squeezing, heaviness, pressure-like sensation in the chest that radiate to the left arm, shoulder or jaw, they may feel shortness of breath, light-headedness, nausea, indigestion, back or jaw pain, and extreme fatigue. These subtle signs can be easily dismissed, leading to delayed diagnosis and treatment.

Another myth is that heart disease is inevitable as we age. While risk does increase after menopause, women are susceptible at any age, especially those with underlying risk factors like hypertension, high cholesterol, diabetes, obesity, and family history. Other less well-known risk factors, like pregnancy complications and psychosocial risk factors, also play a role.

It’s also important to note that heart disease manifests differently in women. While it is common for women to have the usual heart attacks due to sudden occlusion of the major heart arteries from blood clots, they are more likely than men to have heart attacks that involve the smaller arteries that branch out from the coronary arteries—a condition known as microvascular disease or small vessel heart disease.

“Women with cardiovascular risk factors should ensure that they are closely monitored and well-controlled. Educating oneself about the symptoms of heart disease and adopting a heart-healthy lifestyle are pivotal,” emphasises Dr Sim. The encouraging news is that heart disease is preventable: A heart-healthy diet, regular exercise, and effective stress management are crucial, as well as regular health screenings to monitor your cardiovascular risk factors.

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The real heart of the matter is awareness and education—something Dr Sim wants to cultivate with the help of GloW (Global Centre for Asian Women’s Health), a women’s health centre at the NUS Yong Loo Lin School of Medicine. Launched in November 2023, this research facility aims to build an international platform for transdisciplinary endeavours to address women’s major health concerns across the lifespan.

Specifically, it aims to promote early screening, and spotlight the prevention of major causes of death among women such as heart diseases and cancers, as well as focus on maternal and child health.

“Healthcare systems can help by raising awareness through community outreach and education. We need to empower women to put themselves first and take charge of their health,” notes Dr Sim, who conducts regular talks on the subject of heart health. To further its cause, GloW will be holding a fundraising gala dinner at Shangri-La Singapore on 11 May, with an open invitation to guests from the medical field, as well as researchers and health advocates. Funds raised will support collaborative research projects and educational initiatives between GloW and Institut Santé des Femmes (Institute for Women’s Health) at the Faculty of Health in Université Paris Cité.

For more information on the NUHCS Women’s Heart Health Programme and its services, visit nuhcs.com.sg.