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Heart disease in women

Heart disease is no longer a man’s disease but the myths persist. Women and their healthcare providers continue to deal with outdated ideas of who is at risk for heart disease, and the numbers of affected women continue to grow.

Think of the ‘Mad Men’ images of overworked, stressed out male executives who smoke and indulge in too many martinis. In reality, heart disease rates have risen in women. As far back as 1984, women’s mortality rates from heart disease started outnumbering men’s mortality rates. Even more startling are some other statistics:

*The National Cardiovascular Data Registry indicates 3 million American women have some form of heart disease, a much larger number than breast cancer.
*Four hundred thousand women will die from heart disease this year.
*Ten times more women will die from heart disease compared to breast cancer.
*The number of cases of heart disease continues to rise for both men and women, but the mortality rates for men are decreasing while women’s mortality rates are increasing.
*Cardiologists working in Critical Care Units report at least 50% of their patients are female and the numbers are rising.
*The American Heart Association reports in 2004, women accounted for 61% of death from stroke.

Particular types of heart disease in women
As a marker, gender is becoming an increasingly important component of understanding heart disease differences between men and women. Dr. C. N. Bairey-Merz of the Women’s Health center at Cedars-Sinai Medical Center in Los Angeles notes women develop a slightly different form of heart disease compared to men. She explains that women are prone to developing ischemic heart disease.

Ischemia (is-Ke-me-ah) is when blood flow is restricted within a part of the body. Ischemic heart disease (IHD) or cardiac ischemia is a chronic condition and refers specially to the lack of blood flow and oxygen to the heart muscle. Narrow or blocked arteries are unable to pump sufficient amounts of blood for proper heart function. Unless a woman is monitored or tested for heart disease or associated factors, she may be unaware of her risks as IHD develops over several years.

This is part of the problem. Despite increased awareness campaigns, heart disease is still considered primarily a man’s disease. Patients and healthcare providers alike face the fact that little research exists for women and heart disease. Bairey-Merz adds that women are less likely to receive guideline-indicated therapies, making it difficult to select treatment options. For decades, the use of ACE inhibitors has been studied in male patients but not in women. As a result, women are not able to access the same treatment options and the death rates keep rising.

In addition to the increased health awareness campaigns, more work needs to be done to change both social and medical mindsets. With an aging population, women’s heart health must become as important as breast health. Only by debunking the existing myths can women hope to see real advancements in research and treatment to help reverse this alarming trend.

www.americanheart.org

“How is Heart Disease Different in Women: The NHLBI-sponsored WISE Study” presented at the NAMS Annual Meeting 2010 by C. N. Bairey-Merz, MD, Women’s Health Center, Cedars-Sinai Medical Centre in Los Angeles, CA

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