By AMERICAN HEART ASSOCIATION NEWS
Are the hearts of women and men really all that different? It turns out, when it comes to how men and women are treated for ischemic heart disease, the answer is yes.
The American Heart Association on Monday released the first statement that pools all aspects of women’s experiences with ischemic heart disease, a condition that affects blood supply to the heart. The scientific statement was published in the AHA’s journal Circulation.
Statement chair Jean McSweeney, Ph.D., R.N., associate dean of research at the University of Arkansas for Medical Sciences, said the statement combines research on variations in social norms and biological differences between men and women regarding the treatment of heart disease.
“Women’s death rates from heart disease are beginning to decline a little bit, but still at a slower pace than men,” McSweeney said. “There have been small studies conducted and women have been included in some larger studies, but due to limited numbers of women, most data cannot be analyzed by sex or gender.”
This statement, she said, reports the best evidence to date on ischemic heart disease causes, risk factors, symptoms, diagnosis and treatment in women.
Women aren’t being treated to guidelines, McSweeney said, and although ischemic heart disease is the leading cause of death in women, most women still view the disease as one that affects mostly men. Women typically experience ischemic heart disease a decade later in life than men, and women have different symptoms than men, according to the statement.
Because of the uncharacteristic symptoms involved – such as fatigue, nausea and neck or jaw pain – women are often misdiagnosed. And, within one year after a heart attack, a quarter of women 45 years or older will die, compared to 19 percent of men.
“Some clinicians try really hard to make diagnoses, but it’s hard to get the information, because you have to hunt for it,” McSweeney said. “We’re hoping this can be a wonderful guide with a lot of references for them to find answers.”
The statement is useful not only for doctors in making proper diagnoses, but also in educating the public and highlighting the need for more research.
Cardiologist Malissa Wood, M.D., who started the Corrigan Women’s Heart Health Program at Massachusetts General Hospital, said the statement was important, timely and confirms experiences she has had with female patients and patient studies.
“Women need to think about their symptoms and take them seriously, and nurses and doctors should not discount a patient just because she’s a 35-year-old and otherwise healthy,” Wood said. “There are set differences in our hearts, in our blood vessels and in our brains, and it’s not a one-size-fits-all problem or solution.”
Wood said she hopes the statement will encourage more funding for research that looks at sex differences.
According to the statement, women who smoke have a 25 percent greater risk of ischemic heart disease than male smokers. In addition, women over age 35 who smoke are at high risk for cardiovascular disease associated with oral birth control use.
Women, particularly minority women, are more likely to live in undesirable neighborhoods with limited access to grocery stores and no access to quality health services, characteristics that can affect cardiovascular health. Women with a history of preeclampsia – a dangerous spike in blood pressure that occurs late in pregnancy – or diabetes during pregnancy are also at a higher risk of cardiac events.
Until more women are educated about their risks, “it will remain difficult to convince women to undertake necessary behavior changes” to prevent heart disease, the statement said.
The goal, McSweeney said, is to identify women with risk factors or symptoms very early on, before they have a heart attack or other serious problem.
“We need to move the diagnosis earlier so women can be treated and hopefully prevent disability or death due to heart disease,” she said.