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Gender and Heart Disease

 

by the Go Red For Women Editors

Every minute in the United States, someone’s wife, mother, daughter or sister dies from a form of heart disease. And although heart disease death rates among men have declined steadily over the last 25 years, rates among women have fallen significantly less.

Why? A difference in symptoms between men and women may have something to do with it.

Men and women alike can experience the well-known heart attack symptoms like gripping chest pains and breaking out in a cold sweat. But women can also have subtler, less recognizable symptoms such as pain or discomfort in the stomach, jaw, neck or back, nausea and shortness of breath. As a result, women are often unaware that what they’re experiencing is a heart attack. So what happens? Women blow off the warning signs, assuming something else is the problem.

To add to the problem, women’s healthcare providers may misdiagnose these symptoms, and the result is that women discover their heart disease when it’s too late. Men, on the other hand, seem to benefit from having more frequently participated in  clinical trials, and more aggressive diagnostic testing and treatment. So is it any wonder that heart disease is the No. 1 killer of women?

Here are some staggering disparities:

  • Women age 45 and younger are more likely than men to die within a year of their first heart attack.
  • Only 65 percent of women said the first thing they would do if they thought they were having a heart attack was to call 9-1-1.
  • Men are 2 to 3 times more likely than women to receive an implantable defibrillator for the prevention of sudden cardiac death.
  • Previous studies and clinical trials have often been done with inadequate numbers of women in the study population, representing just 38 percent of subjects.
  • In addition, 3/4 of cardiovascular clinical trials do not report sex-specific results, making it difficult for researchers and clinicians to draw conclusions about their effects on women.

Testing, treatment, awareness and symptoms aside, none of these factors explain the entire reason why heart disease affects men and women differently. A study reported in Circulation: Journal of the American Heart Association may offer a clue: Researchers found that the size and pumping ability of the right side of the heart differs by gender and women.

“The right ventricle pumps blood to the lungs to pick up oxygen, so all types of lung diseases — chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, pulmonary hypertension, and sleep apnea — can affect the right side of the heart,” said Steven Kawut, M.D., M.S. and study author.

And guess what? The right ventricle is larger in men than in women. So if it loses its pumping ability or becomes weaker, heart problems are likely to ensue. Also, the blood vessel walls of the very small arteries that branch out from the coronary arteries are more likely to be damaged in women as compared to men. And doctors are still learning about the role hormones play in women’s heart health.

This has to change. Women need to become fierce advocates for their own health. So, it’s time to shout louder, ladies. Go Red and make your voices heard so that no woman is left questioning or ignoring her heart health ever again.