Time to focus on women’s heart health

Every February is REDFEB, heart awareness month, and this year Heart Research Australia is raising awareness about the underdiagnosis and undertreatment of women with heart disease.

University of Sydney research recently revealed women admitted to Australian hospitals with serious heart attacks were half as likely as men to get proper treatment and to die at twice the rate of men six months after discharge.

“We’ve found over recent years that women are doing worse after their heart attacks, they’re more likely to have another heart attack, and more likely to die or have heart failure than men within the five years following their heart attack,” cardiologist Dr Monique Watts, a heart failure cardiologist and specialist in women’s heart disease who works at the Epworth and the Alfred hospitals, said.

Heart Research Australia chief executive officer Nicci Dent said time was critical when it came to heart disease and a “huge” issue with women was the delay to treatment. “Women go to hospital later after symptoms start, which reduces the window of opportunity for effective treatment and increases the risk of complications and damage to their heart.

“There are many things that contribute to this. One big problem is the myth that women aren’t at risk. Traditionally heart disease has been viewed as a bloke’s disease, but globally heart disease is the number one killer of women.”

Dr Watts said another issue was the focus on male-specific symptoms and risk factors.

“Most medical research is conducted in studies of men, and therefore clinical guidelines, symptom checklists and treatments are tailored to men. It means women are diagnosed with heart disease seven to 10 years later than men, and are less likely to be referred for heart tests or heart surgery. We know that smoking, high cholesterol, being over-weight and a sedentary lifestyle are all risk factors discovered from research on men. What isn’t well publicised are the very clear and specific risk factors for women.

“Early menopause, inflammatory conditions such as rheumatoid arthritis and lupus, and complications during pregnancy – such as pre-eclampsia, hypertension, and gestational diabetes – are all important risk factors for women. Even smoking confers a much higher risk of heart disease for women than it does in men.”

Professor Gemma Figtree recently found, through her research supported by Heart Research Australia, that women with no ‘Standard Modifiable cardiovascular Risk Factors’ have the highest chance of dying from their heart attack, with 18 per cent dying at 30 days. This mortality rate is three times that of men with at least one risk factor (6 per cent).

Women also tend to develop symptoms of heart disease at a much later stage of the illness than men and their symptoms are often vaguer or “non-specific”, which can also cause a delay in diagnosis and receiving time critical care.

New research in the US has reinforced the problem of diagnosis and treatment when women present with heart issues despite the fact that guidelines are the same for men and women.

“Our study found that women are advised to lose weight, exercise and improve their diet to avoid cardiovascular disease but men are prescribed lipid lowering medication,” Dr. Prima Wulandari of Harvard Medical School and Massachusetts General Hospital said.