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Women's Heart Disease Needs More Attention, Doctors Say

Additional research on gender differences urged

TUESDAY, Feb. 24, 2015 (HealthDay News) -- Heart disease is the number one killer of U.S. women, yet experts are still trying to pinpoint gender differences to figure out how to best prevent and treat heart disease in women.

For about 20 years, researchers have known that gender differences in heart disease exist. Improvements have occurred in women's care, but more is needed, said Dr. Harlan Krumholz, editor of Circulation: Cardiovascular Quality and Outcomes.

"There still remains a fairly male-centric approach to research," said Krumholz, a professor of medicine at Yale University. Women are still under-represented in studies and, as a result, doctors don't have important information about how women might need different treatments and respond differently than men, he said.

"I still think we have way too much ignorance about these differences," he added.

It's not all bad news though. Women are becoming more knowledgeable about heart disease. In a recent American Heart Association survey, 54 percent of women knew that heart disease is the number one killer of women, compared to just 8 percent who knew that in a 1997 survey.

To help resolve the knowledge gap on gender differences in heart disease, a portion of the March issue of Circulation: Cardiovascular Quality and Outcomes spotlights recent research and includes commentary on what should be done. The findings on this gender gap include:

  • Among a group of women who survived a heart attack, many didn't assess their risk of heart disease accurately, delayed seeking care and didn't have good preventive health habits. Researchers said these factors may help explain why young women have a higher risk of dying from heart attacks than men.
  • Female veterans who needed cardiac catheterization (a procedure that can be used to determine how well the heart is working) were younger, were more likely to be obese and to have post-traumatic stress disorder or depression than the male veterans who needed the procedure, another study found.
  • Women and men have an equal risk of developing heart failure, but women are more likely to die from it. Women are less likely to be referred to receive advanced therapies than men are, research shows. And, if they are recommended for these treatments, the referral comes later than it does for men.
  • Both men and women aren't being properly prescribed medications to keep the blood from clotting (anticoagulants) to treat a heart condition called atrial fibrillation. Atrial fibrillation causes the heart to beat irregularly, which can cause blood clots to form. Previous research has shown that women with this condition are more likely to have a stroke. Researchers found that anticoagulants are being both under- and over-prescribed.

One problem, Krumholz said, is that researchers are still using databases that weren't designed to look at sex differences in heart disease.

"We have to begin to understand not just biological differences, but how do psychosocial factors play in?" he said. "The truth is there are these differences that are important." For instance, among heart attack survivors, women often have more people in their family depending on them than do men, and those responsibilities could impede women's recovery, Krumholz said.

Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City, reviewed the research. She said the studies show that "there is still a great deal of work that needs to be done in the field of women and heart disease."

The disparities in the amount of research being done on women results in unanswered important questions, she said, including how best to diagnose and treat women. Steinbaum agreed that women do not always assess their own heart risks accurately and may have poor prevention habits and delay getting care.

"We need an action plan now," she said. "And it needs to begin with every woman knowing that heart disease is her number one risk." This will help women take heart health seriously and be assertive in getting the proper diagnosis and treatment, Steinbaum said.

More information

To learn more about heart disease in women, visit the American Heart Association.

SOURCES: Harlan Krumholz, M.D., professor of medicine, Yale University, and editor of Circulation: Cardiovascular Quality and Outcomes; March 2015, Circulation: Cardiovascular Quality and Outcomes; Suzanne Steinbaum, D.O., director, women and heart disease, Lenox Hill Hospital, New York City
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