Silent Signals: Uncovering Impact of Angina on Women in India

Time of India

19-06-2025

New Delhi: While women face many health challenges throughout their lives, heart disease stands out as one of the most serious — causing more deaths and disability than any other condition worldwide.
A 2016 report by the
India
n Council of Medical Research identified heart disease as the leading cause of illness in India. According to the National Family Health Survey (2019–20), about 0.7% of women and 0.9% of men in India report having heart disease.
India's death rate from heart disease already exceeds the global average — and studies show that women may be even more at risk. Conditions like
angina
often present subtly, with symptoms that are easy to miss but can lead to higher risks.
To spotlight this critical issue, ETHealthworld, in collaboration with global healthcare leader
Abbott
, hosted a webinar titled Her Heart Matters: Understanding Angina and
Coronary Artery Disease
in Women. The session brought together medical experts to explore the unique cardiovascular challenges faced by Indian women.
The expert panel featured Dr Jyotirmoy Pal President, Association of Physicians of India (API);
Dr Agam Vora
, Honorary General Secretary, Association of Physicians of India (API); Dr. Gurpreet S Wander, Chief Cardiologist, Hero DMC Heart Institute, Ludhiana; Dr. Sarita Rao, Senior Interventional Cardiologist and Director Cath Lab, Apollo Hospitals, Indore; Dr Rohita Shetty Head of Medical Affairs, Abbott India. The discussion was moderated by Prathiba Raju, Senior Assistant Editor, ET Healthworld.
Exploring the underlying causes of angina, Dr Jyotirmoy Pal explained that while
non-communicable diseases
(NCDs) accounted for a third of deaths at the time of India's independence, decades of
lifestyle
and metabolic shifts have dramatically altered the landscape— with cardiovascular diseases now emerging as the leading cause of mortality.
Angina, commonly experienced as chest pain, is one of the most recognizable early warning signs of heart disease. Dr. Gurpreet S. Wander added that approximately 60–65% of individuals with coronary artery disease report experiencing angina symptoms.
Discussing key risk factors for angina, Dr. Wander emphasized that among the eight major contributors to heart disease — including high blood pressure, diabetes, obesity, and stress — genetics and lifestyle choices, particularly tobacco use, pose the greatest risk for individuals under 60.
He also noted that while women benefit from a degree of natural protection against heart disease due to hormonal factors, this advantage is significantly diminished in the presence of diabetes.
Experts further highlighted a critical gap in research: women comprise only about 20% of participants in heart disease clinical trials. As a result, most treatment protocols are based predominantly on male-centric data, making it more challenging to develop care strategies tailored specifically to women's cardiovascular health.
Diagnosis Dilemma
Speaking on the importance of early detection, Dr. Jyotirmoy Pal emphasized that recognizing angina symptoms promptly can lead to timely intervention — potentially saving lives. However, in India, recurring chest pain is often misdiagnosed as Acid Peptic Disorder (APD), delaying appropriate cardiac care.
Dr. Agam Vora added that there's a common misconception that only individuals with conditions like diabetes or obesity are at risk for angina. 'That's not always the case,' he noted, stressing the need for clinicians to adopt modern diagnostic tools — especially when interpreting ECG results proves challenging.
Dr. Wander further explained that angina can sometimes present with symptoms like burping, which are frequently mistaken for acidity. 'If the discomfort isn't localized and lasts for 3 to 5 minutes, it could be a sign of heart-related chest pain,' he cautioned.
The panel also underscored the value of non-invasive diagnostic tests — such as treadmill tests, stress echocardiography, and cardiac imaging — in identifying angina early. These tools can help avoid diagnostic delays, which is critical, as untreated angina can escalate into a
heart attack
, posing serious, potentially life-threatening risks.
Gender-Based Differences
Dr. Rao explained that heart disease symptoms in women can be quite different from those in men. Instead of the typical chest pain, women may feel breathless, break into a sweat, or experience symptoms like acidity, heartburn, or even nausea.
She also noted that diagnosing heart issues in women can be more complex. For example, their ECGs may show subtle changes, and they're more likely to test positive during a treadmill test. Women also experience a type of heart condition called microvascular angina, which affects the smaller blood vessels and often doesn't show up on standard heart scans like a coronary angiogram.
While women do have some natural hormonal protection against heart disease, Dr. Rao pointed out that they also face unique risks — especially during and after pregnancy. Conditions like gestational diabetes and high blood pressure can increase a woman's chances of developing heart disease later in life.
She also highlighted that early menopause, Polycystic Ovarian Disease (PCOD), and autoimmune disorders can raise the risk of heart problems even further. That's why it's important for women to stay informed and proactive about their heart health.
Solutions to change the course
Coronary artery disease (CAD) ranks among the leading causes of death from non-communicable diseases. While it is often diagnosed later in life, Dr. Wander emphasized that its origins can be traced back much earlier. Adopting healthy lifestyle habits early — and maintaining them consistently — plays a crucial role in preventing or delaying the onset of heart disease.
Dr. Rao emphasized that regularly checking your blood pressure, cholesterol, and blood sugar — along with living a healthy lifestyle — can greatly reduce your risk of heart disease. Avoiding smoking and alcohol also plays a big role. These simple habits can help you stay healthier and be better prepared for any future health risks.
Abbott's Efforts for Better Heart Health
Dr. Rohita Shetty shared some of the steps Abbott is taking to support women's heart health, especially around angina. As part of its 2030 global goals, Abbott is working to fight non-communicable diseases like diabetes and heart conditions.
Because angina often shows up differently in women and can be hard to recognize, there's a strong need to raise awareness. To help close this gap, Abbott collaborated with the Association of Physicians of India (API) to launch Angina Awareness Week in 2024. As part of this effort, Abbott introduced the OPTA (Optimal Treatment of Angina) initiative, which includes three helpful tools — a checklist, a questionnaire, and a clinical approach — all designed to improve how angina is diagnosed and managed.
This year, the spotlight is on women — with a focus on improving their heart health and overall quality of life. Abbott's awareness initiatives aim to empower individuals with the knowledge they need to take control of their heart health and make informed choices for a healthier future.
To summarize, with rising rates of obesity, hypertension, and hereditary risk factors, experts caution that the burden of heart disease is likely to continue growing. The good news is that this trend can be changed. By making healthier lifestyle choices, scheduling regular health checkups, and leveraging advanced diagnostic tools, individuals can take meaningful steps to reduce their risk — helping to build stronger, healthier families and communities.
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