Lifestyle affects women's life expectancy and quality-of-life

Women living in Austria today have a statistical life expectancy of 84 years, so that, on average, they live 4.7 years longer than men. However, when it comes to years of good health, they are on a par with men and the increased prevalence of diabetes will slow down the increase in life expectancy. "Obesity and diabetes are the major risk factors for cardiovascular disease, the commonest cause of death in women," says gender-medicine expert Alexandra Kautzky-Willer from MedUni Vienna, speaking in anticipation of International Women's Day on 08 March. Moreover, although women live longer than men, they do not necessarily do so with fewer health problems.

Between one and two years of the longer life expectancy that women enjoy over men are down to biological factors. Women have a stronger immune system, a medically more favorable body fat distribution and hormonal protection of their blood vessels in the form of estrogen. They therefore have an advantage over men—at least up until the menopause. The rest is down to lifestyle factors that enable women to live longer. However, the average age at which the first chronic diseases manifest is practically the same in both sexes, approximately 57 years of age, in Austria. And the increased prevalence of diabetes, especially among women, means that chronic diseases are increasingly occurring even earlier.

Cardiovascular disease is the number one cause of death

At 42%, cardiovascular disease is by far the commonest cause of death in women in Austria, as opposed to 35% in men. "Women are more likely to die from cardiovascular diseases, that is to say heart attacks, strokes, heart failure or arrhythmia, than men," explains Alexandra Kautzky-Willer. Even while a woman is still young, it is possible to make a relatively reliable assessment of whether she belongs to a risk group and will suffer from cardiometabolic diseases at some point in her life.

During the course of their lives, women go through two particular stages, in which any irregularities can indicate a subsequent risk of cardiovascular disease: the reproductive stage and any pregnancies plus the menopause. Early onset of menstruation or menopause, irregular periods, polycystic ovary syndrome or other irregularities in young women are all indicators of a risk of cardiovascular disease later on in life. Certain complications during pregnancy can also points towards subsequent disease. "A pregnancy is a kind of stress test for the female body," explains Alexandra Kautzky-Willer, "pre-eclampsia, a particular form of hypertension that occurs during pregnancy or even uncomplicated gestational hypertension or so-called gestational diabetes can be indicators of cardiometabolic disease in later life."

During the menopause, levels of estrogen, which had previously had a certain protective effect upon blood vessels and glucose, lipid and bone metabolism and also upon the immune system, fall sharply. If women in the 50-60 age group suffer from diabetes, high blood-pressure and dyslipidaemia, they go into the high risk group for cardiovascular disease. "Women with classical metabolic syndrome have a three times greater risk of acute heart attack or other cardiovascular diseases with a high risk of mortality."

Women who have survived their reproductive years and the menopause without any signs of cardiovascular disease or diabetes, have a good chance of enjoying an additional ten healthy years and a longer life expectancy, so long as the following criteria are met: they do not smoke, do at least 210 minutes of exercise per week, eat a healthy diet and keep their weight within the normal range and do not drink more than 15 g of alcohol per day. For an optimized lifestyle, Kautzky-Willer additionally recommends: not sitting for too long, making sure you have enough good-quality sleep and regulating blood glucose and lipid levels and blood pressure. "In this way, women can reduce their risk of diabetes by 75% and, if they already have diabetes, they reduce their risk of developing cardiovascular disease and their own mortality risk by 50%."