Pakistani women face high heart disease burden

JACC study finds Pakistan has highest female ischaemic heart disease death rate among five South Asian countries; experts cite hypertension, diabetes, obesity and screening gaps

IV Report

KARACHI: Pakistani women had the highest age-standardised death rate from ischaemic heart disease among five South Asian countries in 2021, with experts linking the burden to hypertension, diabetes, obesity, physical inactivity and gaps in screening and follow-up.

The finding, from a 2026 study published in JACC: Asia, was highlighted at a press conference in Karachi on Monday ahead of World Heart Day, to be observed on September 29 with the theme “Don’t Miss a Beat”.

The study compared Pakistan, India, Bangladesh, Nepal and Bhutan using Global Burden of Disease estimates. Pakistan was also the only country in the comparison where deaths in relation to estimated cases were higher among women than men, at 4.4 per cent against 3.1 per cent. High blood pressure and diets low in vegetables and fibre were identified among the leading contributors.

Speaking at the launch of the “Her Heart Matters” campaign, cardiologists, physicians and gynaecologists said cardiovascular disease among women remained under-recognised because of misconceptions, inadequate screening and poor follow-up during and after pregnancy.

The campaign, launched by PharmEvo in collaboration with the Pakistan Cardiac Society, Society of Obstetricians and Gynaecologists of Pakistan (SOGP), Pakistan Society of Internal Medicine and Go Red for Women, aims to promote cardiovascular screening and awareness among women and healthcare professionals, according to a company press release.

Prof Dr Mansoor Ahmed, Professor of Cardiology at the Karachi Institute of Heart Diseases, said the longstanding belief that women were less vulnerable to heart disease had been disproved. He said women often placed their own health behind household responsibilities, while limited physical activity and inadequate attention to their medical needs increased their risks.

He said diabetes had become a major public health problem in Pakistan and frequently occurred alongside cardiovascular disease. Women with diabetes, hypertension or obesity therefore required regular assessment to identify cardiovascular disease before serious complications developed.

Prof Dr Tazeen Abbas, Secretary General of SOGP, said women's cardiovascular health required attention during pregnancy, after childbirth and following menopause. She cautioned against stopping prescribed medicines during pregnancy or discontinuing blood pressure treatment after delivery without medical advice.

Hypertension detected during pregnancy was often forgotten after childbirth, she said, although the associated risks could persist. Pregnancy-associated cardiomyopathy, in which the heart muscle becomes weakened during or around pregnancy, could also have serious consequences if not diagnosed and treated promptly.

She also cited anaemia and closely spaced pregnancies as additional health burdens and stressed the importance of family planning, birth spacing and continued medical follow-up. Regular exercise and reducing fried foods, bakery products, soft drinks and sugary juices were also advised.

Prof Dr Halima Yasmeen, Chairperson and Head of Department at Jinnah Postgraduate Medical Centre and an executive member of SOGP, said heart disease had been detected in around four per cent of pregnant women screened through her clinical service.

Pregnancy, she said, provided an important opportunity to identify hypertension and previously undiagnosed heart disease. Women with cardiac problems required coordinated care involving obstetricians, physicians and cardiologists during pregnancy and after delivery.

Prof Dr Shabnam Naveed, Head of Medicine at JPMC and Jinnah Sindh Medical University, said inadequate screening was among the major barriers to preventing cardiovascular disease in women. She said cardiovascular risk factors were present in more than 90 per cent of women attending the JPMC diabetes clinic, while cautioning that the figure represented a high-risk hospital population.

Prof Dr Fawad Farooq, General Secretary of the Pakistan Cardiac Society, said stress and physical inactivity were additional contributors. He said women could incorporate walking and other forms of physical activity into their routines despite limited time or space.

He also pointed to pressure on specialised cardiac hospitals, saying Pakistan lacked an effective primary and secondary cardiovascular care network. At the National Institute of Cardiovascular Diseases, he said, spaces intended for one patient sometimes accommodated several, while multiple heart-attack patients could arrive simultaneously.

Tertiary hospitals alone, he said, could not manage the country's growing cardiovascular burden. He also cautioned that some patients stopped prescribed medicines within weeks of undergoing angioplasty, increasing the risk of further complications. Stronger primary care, follow-up and adherence to treatment were needed to reduce repeat heart attacks and pressure on specialised hospitals.

Samar Iqbal Jafri, Director Marketing and Sales at PharmEvo, said the company's existing initiatives on diabetes and hypertension aimed to identify people unaware of their conditions, while the new campaign would focus specifically on women's cardiovascular health.

Photos courtesy: PharmEvo