Mandakini Gupta, New Delhi: Women are believed to be protected against heart disease because of the female sex-hormone oestrogene, which, among other things helps in increasing HDL or good cholesterol and decreases LDL or bad cholesterol.

But heart disease in women is extremely complicated. Also, lifestyle changes such as smoking, stress and eating habits are slowly eroding the protection.

"Women din’t get heart disease till they were 60 years old. Now that age has come down by 10 to 15 years. The women are catching up with the men,” says Cardiac Surgeon, Dr Naresh Trehan.

Some basic tests such as the treadmill test often show a false result in women.

Research studies funded by the National Institutes of Health which is an agency of the US department of health show that the treadmill stress test gives false results in up to 40 per cent women.

Twenty-eight-year old Rukmini had a heart attack last year. Ironically the treadmill test results had put her in the clear. But a month later she had a minor heart attack.

"What shocks me more is that because I’m a woman. My heart disease might not show up with basic tests. And even though my tests showed nothing wrong. I still had an attack,” says Rukmini.

According to a study conducted by Yale University a woman who smokes and is also using oral contraceptives is up to 40 times more likely to have a heart attack than a woman who does not use either.

The combination can increase risk of clotting or thrombosis in the legs or lungs, which causes heart attacks and strokes.

The solution lies not in stopping the pill but in quitting smoking so that you get that all protecting oestrogen level in balance.