Davina McCall, 59, reveals cardiovascular disease diagnosis – 8 symptoms women need to know now

Speaking on a special British Heart Foundation episode of her podcast Begin Again alongside heart attack survivor Louise McGill, Davina McCall revealed that she has been diagnosed with cardiovascular disease (CVD).

‘I also have cardiovascular disease and this is a very important conversation to have,’ Davina said when chatting to Louise, who explained that before her heart attack, tests had shown her cholesterol to be slightly high.

‘That's exactly what happened to me,’ Davina responded. ‘I had high cholesterol and I'd had it for quite a long time and it was deemed because I had high good cholesterol that offset the bad or something?’

‘Cardiovascular disease is an all-encompassing term that includes many different conditions affecting the heart and blood vessels throughout the body,’ explains private GP and co-founder of Coyne Medical Dr Lucy Hooper, who has a clinical interest in cardiovascular health and prevention.

‘This includes coronary heart disease [the leading cause of heart attack], strokes, peripheral arterial disease, heart failure and abnormal heart rhythms.’

Meanwhile, heart disease, she adds, ‘refers more specifically to conditions affecting the heart itself’.

In simple terms, all heart disease is CVD, but not all CVD is heart disease.

‘When we think about cardiovascular disease, we often imagine someone clutching their chest and collapsing, and usually we probably picture that person as male – but cardiovascular disease doesn’t always present like that,’ notes Dr Hooper. ‘The sudden heart attack or stroke someone experiences is biologically something that has usually been decades in the making.’

‘Cardiovascular disease deserves a much higher place on our list of things to focus on in women’s health because it’s the leading cause of death among women globally, as highlighted by The Lancet Commission on Women and Cardiovascular Disease in 2021,’ adds Dr Hooper. ‘Women are still frequently underdiagnosed, undertreated and underrepresented in cardiovascular research.’

With that in mind, Dr Hooper says the following symptoms deserve attention.

1. Chest pain

‘Chest pain remains the most common symptom of a heart attack in both males and females. However, women are statistically more likely than men to experience a heart attack without chest pain – especially younger women under 45,’ says Dr Hooper, citing a large study of more than one million patients that found heart attacks without chest pain occurred in 42% of women compared with 30% of men.

2. Chest tightness or discomfort

‘Sometimes the chest symptoms aren’t really pain; they might be more of a tightness or discomfort in the chest area,’ she adds.

3. Pain or discomfort in the shoulders, arms, back, neck or jaw

‘Sometimes that discomfort isn’t felt in the middle of the chest – it might be more towards the shoulders, arms or back, or extend into the neck and jaw area.’

4. Breathlessness

While it can be easy to put this down to simply getting older, being tired or becoming unfit, Dr Hooper says that ‘if you’re feeling breathless or really exhausted doing an activity that you used to be able to do comfortably, that can be a warning sign – for example, getting breathless walking up a flight of stairs that previously you would have managed easily’.

5. Fatigue

‘Some symptoms can also easily be put down to menopause in women, particularly palpitations and tiredness,’ adds Dr Hooper. ‘These are symptoms that could be related to hormonal changes, but we shouldn’t automatically assume that menopause is the answer.’

6. Palpitations

Palpitations – the sensation of your heart beating unusually fast, hard or irregularly – can also be a symptom that warrants attention, particularly if they are new or accompanied by other symptoms.

7. Lower-leg pain

Another key but perhaps lesser-known sign, says Dr Hooper, can be lower-leg pain – especially in the calves when walking, which typically goes away at rest.

‘This can indicate peripheral arterial disease, where the arteries supplying blood to the legs have become narrowed.’

8. Nausea or sweating

Nausea and sweating, she flags, can also signal that something might be amiss.

‘When these symptoms come on suddenly and don’t go away, that’s obviously a worrying sign and a reason to seek immediate medical help,’ adds Dr Hooper. ‘But some people will notice symptoms that come and go.’

‘Sudden or persistent symptoms that could indicate a heart attack, even without chest pain, should prompt a call to 999,’ she warns. ‘But the most important mistake that many people make is waiting for an event like a heart attack to occur before worrying about their cardiovascular disease risk.’

Davina mentioned on the podcast that she had previously been told higher levels of ‘good’ cholesterol helped cancel out the ‘bad’, which Dr Hooper says ‘is an incredibly common misconception and something I hear every week in clinic.’

‘For many years, we did talk about HDL as “good cholesterol” and LDL as “bad cholesterol” – the idea was that having lots of healthy, or “good” HDL cholesterol would protect you against the harmful effects of elevated LDL cholesterol,’ she explains, adding that the idea was based on observational studies where researchers had found that people with higher HDL cholesterol levels generally had fewer heart attacks.

‘But that was an association; it wasn’t what we call causation, or evidence that HDL cholesterol itself was providing that protection.’

‘That’s why we no longer recommend trying to raise HDL cholesterol as a treatment target on its own,’ says Dr Hooper. ‘Instead, we focus on the cardiovascular risk factors we know are causative.’

Exploring potential cardiovascular risk factors – which include but are not limited to menopause, PCOS, gestational diabetes and high cholesterol – as early as possible can help identify and manage CVD risk.

‘High cholesterol usually causes no symptoms,’ flags Dr Hooper. ‘That’s why I encourage women to know their actual LDL cholesterol number rather than just being told it’s “okay”.’