Women face unique challenges when it comes to heart health, according to a recent statement from the American Heart Association. The statement highlights the need to improve heart attack treatment and prevention in women.
Published in the medical journal Circulation, this is the first scientific statement from the American Heart Association to address heart attacks specifically in women. Although heart disease is the No. 1 killer of all Americans, it affects men and women differently in many ways. After conducting a thorough review of recent studies, here’s what experts shared about the diagnosis, treatment and prevention of heart attacks in women.
First, experts confirm that heart disease is an equal-opportunity killer. In fact, heart disease has killed more women than men in the United States since the early 80s. The good news is that efforts to increase awareness have reduced heart disease mortality in women since 2000. But we still have a long way to go in improving diagnosis, treatment and prevention of heart disease in women.
As experts explain, heart attacks affect women and men differently. Women often experience their first heart attack at an older age, possibly due to the protective effect of estrogen on blood vessels. On average, women experience their first heart attack at the age of 72 compared with 65 years for men.
Research also suggests that cardiovascular risk factors like smoking, diabetes and depression are more potent in women than men. For example, smoking increases heart attack risk seven-fold in women younger than 55, and obesity triples women’s risk for heart attack. Studies also have found that high blood pressure and diabetes increase heart attack risk more in women than men.
However, it’s important to note that heart attacks affect certain women differently. Minority women tend to experience heart attacks at a younger age and have poorer outcomes than white women. Black women suffer more heart attacks than all other racial and ethnic groups in the United States. Minority women tend to have more cardiovascular risk factors like diabetes and hypertension than white women.
Experts also point out that heart attack symptoms differ in women and men. Women are less likely to have central chest pain and more likely to experience “atypical” pain such as shortness of breath, weakness, fatigue and indigestion. Unfortunately, women also tend to seek medical attention later than men and are less frequently referred for appropriate treatment. For example, women are less likely to use therapies like blood pressure-lowering medication after a heart attack, despite their proven benefits. As a result, women tend to have worse outcomes in the year following their first heart attack.
Based on this evidence, authors highlight the need to improve sex-specific research on heart disease. Although women represent roughly half of participants in registries and observational studies, they make up only 20% of clinical trial patients. So not only are sex-specific studies desperately needed, we must increase female participation in such studies. Through additional research and education, experts hope to better address sex-specific differences related to heart disease and improve outcomes in women.