By Meeney Dhir, MD
eart disease is the number one killer for women (and men). It will kill more women than the next six causes of death combined, including all types of cancer. It claims almost half a million women each year. One woman dies every minute of some form of heart disease.
Surveys consistently find that women (and often their physicians/ health care providers) perceive cancer, particularly breast cancer, to be a greater health risk for them, while heart disease is seen primarily as a man’s disease. The truth is, only 1 in 30 American women die from breast cancer; while 1 in 2.6 die from cardiovascular disease (CVD). In a recent poll, 51 percent of women identified breast cancer as their likely number one killer, while only 13 percent got it right! This is a widely prevalent problem that is clearly under recognized.
Caring for a woman’s heart is made more difficult by the fact that the symptoms they complain of are often atypical; we women are not men! When they are having a heart attack, women will often not present with the classic picture of the crushing chest pain and sweat pouring down their face…often it is just unexplained shortness of breath with minimal chest discomfort, anxiety, an impending sense of doom, or just uncontrollable “heartburn.”
Even if the correct diagnosis is made in time, there is data to suggest that women often do not get treated as aggressively as men: they are less likely to get the right drugs, the indicated procedures, and are less likely to get stent implants. After a heart attack, women remain at higher risk. Not only are they more likely to die suddenly, 35 percent will have a second heart attack, about 46 percent will be disabled with heart failure and 11 percent will have a stroke.
Less than one in five physicians recognizes that more women die of heart disease than men each year. Among primary care physicians, only 8 percent know that more women than men die each year from CVD. This under recognition of heart disease in women explains why the gap between male and female deaths is widening. The advances in cardiology are reflected in the lower mortality rate in men over time, but women have not reaped the benefit of these successes. Also, despite the advances in breast cancer, the mortality graph is not trending down…the real killer remains untamed in women!
Many minorities, including Hispanic, African American and Native American women, have a greater prevalence of risk factors or are at a higher risk of death from heart disease, stroke and other CVD, but this risk is often not recognized.
There are many dimensions to this problem. First and foremost is the lack of awareness among women and their providers. Women are likely to place the needs of those around them ahead of their health. It is a widely prevalent myth that women don’t get heart disease until they are “old” and they can postpone taking care of their heart. While they get annual mammograms, how often do women get counseled on heart health? Women should be encouraged to “know their numbers”: weight, blood pressure, fasting glucose, lipid profile. Stress testing may be indicated in some women based on their risk assessment.
In light of this, a “Go Red” campaign has been launched to empower women through education and awareness. Why do women love the color RED? Is it because it is the color of vibrancy, dynamism and passion for life--or is it because they love their hearts?
We all proudly sport the pink pins to mark our support for breast cancer, but it is time we recognized another friend, the red dress pin.
References:
1. Thom T, Haase N, Rosamond W, et al. Heart Disease and Stroke Stati-stics –2006 Update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113:e85–e151.
2. Mosca L, Ferris A, Fabunmi R, et al. Tracking women's awareness of heart disease: an American Heart Association national study. Circulation. 2004;109:573–579.
3. Women’s heart risk underestimated by doctors, resulting in less preventative care than in men. Circulation. NR05-1011. February 1, 2004.
Meeney Dhir, MD FACC FASE, is a
Cardiologist specializing in Women & Heart disease, Cardiac Imaging & Vascular Medicine.
