The Killer Nobody Talks About in Women
Ask most Nigerians what the leading cause of death in women is and they will say cancer — probably breast or cervical cancer. The correct answer is heart disease. Globally and in Nigeria, heart disease kills more women than any cancer. Yet it receives a fraction of the attention, awareness, and concern that cancer does. One major reason is that women’s heart disease presents differently from men’s — often with subtler, vaguer symptoms that are easier to dismiss or attribute to other causes. Women with heart attacks are more likely to be sent home from emergency rooms with a diagnosis of anxiety or indigestion. They are less likely to be investigated promptly. And they are more likely to die from a first heart attack than men. This disparity exists because medicine has historically studied heart disease mostly in men and assumed the findings applied equally to women. They do not.
How a Heart Attack Feels Different in Women
- Chest discomfort is less likely to be the classic crushing, vice-like pressure — it may feel like tightness, fullness, or even just an unusual awareness of the chest
- Jaw pain, neck pain, or pain in the upper back — occurring without obvious chest pain
- An overwhelming, unexplained fatigue — not the tiredness of a busy day, but a bone-deep exhaustion that comes on for no clear reason, sometimes in the days before a heart attack
- Shortness of breath that comes on without exertion
- Nausea, vomiting, or what feels like indigestion during what is actually a cardiac event
- Dizziness, cold sweat, or a feeling that something is very wrong that you cannot pinpoint
- Important: these symptoms do not confirm a heart attack — but they mean you should get medical attention the same day, not take antacid and go to bed
Risk Factors That Are Specific to Women
- Pre-eclampsia during pregnancy — a woman who had pre-eclampsia is at significantly increased lifetime risk of heart disease and stroke, even years after the pregnancy
- Gestational diabetes — another pregnancy condition that predicts future cardiovascular risk
- Polycystic ovary syndrome (PCOS) — associated with insulin resistance, high blood pressure, and an unfavourable lipid profile
- Early menopause — women who go through menopause before age 40 (whether natural or surgical) lose the cardioprotective effect of oestrogen much earlier
- Autoimmune conditions like lupus and rheumatoid arthritis, which are more common in women and cause chronic vascular inflammation
- All the standard risk factors also apply: high blood pressure (which is extremely common in Nigeria), diabetes, high cholesterol, smoking, obesity, and physical inactivity
The Hypertension Problem in Nigeria
Hypertension — high blood pressure — is the single most important driver of heart disease and stroke in Nigerian women, and it deserves special emphasis. Studies suggest that hypertension affects more than 30% of Nigerian adults, and awareness rates are poor. A significant proportion of Nigerian women with hypertension do not know they have it, because high blood pressure causes no symptoms until it damages an organ. By the time a stroke happens, the blood pressure has often been elevated for years. The only way to know is to measure it. Every woman over 30 should know her blood pressure. Every woman over 40 should have it checked at least annually.
What You Can Control
- Know your blood pressure, blood sugar, and cholesterol — the three silent cardiovascular risk factors
- Reduce salt — excess dietary salt is the leading driver of hypertension in Nigeria. This means less salt added during cooking, less stock cubes used heavily (Maggi and similar seasonings are high in sodium), and less of processed and packaged foods
- Exercise most days of the week — walking, swimming, dancing, any sustained physical activity for at least 30 minutes
- Maintain a healthy weight — abdominal obesity is a major cardiovascular risk factor
- Stop smoking — women who smoke have a dramatically higher risk of heart attack at a younger age
- Eat more vegetables, fruits, legumes, and oily fish; less fried foods, refined starch, and processed meat
- If you have been diagnosed with hypertension or diabetes and placed on medication — take it every day, even when you feel fine
How Doc on Wheels Can Help
Doc on Wheels can arrange a blood pressure check, blood glucose test, and cholesterol test at your home. If your results are concerning, our doctors can advise on next steps and connect you with a cardiologist. If you experience any of the heart-related symptoms described above, speak to a doctor through the app the same day. And if you have a history of pre-eclampsia, gestational diabetes, or PCOS and have never had a cardiovascular risk assessment, this is a conversation worth starting.