Lorna Fedelem, MD
Despite the American Heart Association (AHA) stating that one in three women will die of heart disease and that there’s an increase in heart disease in women under age 55, there are still many disparities in how women pursue preventive measures and receive care.
For instance, women wait more than 30 percent longer than men to get to a hospital after first experiencing symptoms of a heart attack. Women are also 50 percent more likely to be diagnosed incorrectly after a heart attack.
Heart disease is the number one killer of both men and women in this country. The most important thing for all women to understand is that 80 percent of the time, heart disease is preventable.
What drives these gender disparities? Experts say they’re caused by a few factors.
1. Lack of awareness
Less than 60 percent of women recognize that heart disease is the leading cause of death among women.
That statistic has improved over the last couple of decades, but not to where it needs to be. Physicians need to do a better job of educating the general population, especially women. Even women who had a heart attack are more likely to think they will die from some form of cancer rather than heart disease, especially breast cancer, and sometimes even lung cancer. As often as women think about an annual mammogram, they should also be thinking of visiting their PCP for their yearly heart checkup.
2. Differing symptoms from men
While men and women most often present with chest discomfort in the middle of the chest under the sternum, women can experience more subtle and different signs of heart disease.
Subtle signs women experience may include:
• shortness of breath
• back pain
• jaw pain
When women are not aware of the symptoms being connected to a cardiac event, they don’t get to the emergency room in time and there is more likely to be damage to the heart muscle. When women and men don’t get appropriate therapy immediately, then that muscle is forever scarred and more likely to have heart failure or arrhythmias, or recurring events.
3. Lack of women in studies
There is not nearly as much research about women and heart disease as there is on men. Up until recently, heart disease was felt to be a man’s disease, therefore, women were not included in medical research. Today strides have been made and more women are included in studies.
It wasn’t until 1993 that the NIH made a statement that women need to be included in trials as much as men. Even though that was 28 years ago, it wasn’t until the past 15 years that research for women finally started to become equal.
Now the American Heart Association has an educational initiative for women to really understand their heart disease risks and the AHA is also supporting research and science.
What can women do?
Family history of heart disease puts women and men at increased risk, and both genders need to practice the same lifestyle habits for heart health, including:
drinking in moderation, as excess alcohol consumption can increase blood pressure
exercising, which is a recommendation of moderate activity for 30 minutes, five days a week
maintaining a moderate weight
getting adequate sleep, ideally seven hours per night
Additionally, research is showing that women who have abnormalities associated with arthritis like systemic lupus or rheumatoid arthritis, which are associated with chronic inflammation, may be at greater risk for heart disease, as well as women who experience hypertension or gestational diabetes during pregnancy.
While it’s not known why these conditions put women at increased risk, it may have to do with changes that occur in the coronary arteries or in the endocrine system that predispose women to coronary artery disease. Another thought is that the conditions change the arterial wall causing endothelial dysfunction.
The bottom line is that going for a wellness visit every year, where you can get screened for the markers of heart disease with a primary care physician is important. Prevention begins there. Develop a relationship with your doctor, advocate for yourself, and make lifestyle changes.
When talking to your doctor:
Be honest and upfront about your symptoms. Do not feel embarrassed!
Write down your questions and concerns and bring them to your appointment.
If possible, bring a family member or close friend. Sometimes it helps to have two sets of ears when hearing from your doctor.
Take notes so you can look them over later.
Learn how to access your records, get test results, and a list of your medications. Many of these things can be found electronically.
Call your doctor today to schedule an appointment. Early detection and treatment are key!