- Researchers say women are less likely to be prescribed heart medications such as statins.
- Experts say this makes it even more important for women to understand cardiovascular health risks and symptoms.
- They urge women to be better personal advocates and to adjust their lifestyle to improve their heart health.
- They also say women should be aware of mental health issues and how they can affect cardiovascular health.
The shift away from seeing heart disease as a “man’s disease” is the focus of many programs, including the American Heart Association’s Go Red for Women.
However, according to a recently published systematic review of how women are treated for cardiovascular issues, there’s still a long way to go toward heart health equity.
The study, published in the Journal of the American Heart Association (JAHA), took a deep dive into 43 international studies with data on primary care prescriptions among more than 2 million patients who were at risk for heart attack.
Almost 30 percent of those study participants were women with an average age between 51 and 76.
Researchers say the systematic review found that women are prescribed classic treatments for heart disease significantly less often than men.
Statins were prescribed 10 percent less, ACE inhibitors 15 percent less, and aspirin 19 percent less.
“The historical suggestion was long that cardiovascular disease is considered to be a man’s disease,” said Sanne Peters, PhD, a study lead author and a research fellow in epidemiology at The George Institute for Global Health in the United Kingdom, as well as an associate professor at the University Medical Center in the Netherlands.
“We can see from this that this is still a message we see sometimes,” she said.
Peters told Healthline that particularly with older physicians, there can still be a tendency to overlook some preventive steps for women and cardiovascular disease.
Women and heart disease
For at least one cardiologist, the strength of this study comes from the wide breadth of data it drew from.
“Numerous studies have suggested that both women and men are not getting [preventive heart medications they may need], but women to more of a degree,” Dr. Elizabeth Jackson, MPH, FACC, FAHA, a professor in the Division of Cardiovascular Disease at the University of Alabama at Birmingham, told Healthline.
“The strength of this finding is it allows us to look at a huge number of patients and draw from that. That’s the strength of a systematic review,” she said.
Jackson noted that medical professionals “should not be automatically treating women the same as men,” but she also points out “there is an overlap.”
She said basic preventive health steps such as taking aspirin, for example, “should not have a noticeable difference in usage between men and women.”
“Heart disease has long been thought of as a man’s disease,” said Dr. Ileana Piña, MPH, FAHA, a professor of medicine at Wayne State University in Michigan, a clinical professor of medicine at Central Michigan University, and a lead national volunteer for the American Heart Association.
“The reality is cardiovascular disease is the number one killer of women annually. It claims more women’s lives than all forms of cancer combined,” she said.
Heart disease and stroke can affect any woman at any age.
In fact, recent research shows there’s an increase in heart disease in women under age 55.
Experts say gender disparities in research, as well as misconceptions and a lack of understanding of symptoms and risk factors, have caused women to be overlooked when it comes to understanding how cardiovascular disease may impact them differently.
Experts say women can use this research to take action by learning, asking, and doing.
“The best thing a woman can do is know her risk factors,” said Jackson. “There’s a lot of information out there.”
Jackson points to the American College of Cardiology’s “Cardio Smart” program as well as the Heart Association’s Go Red for Women program.
“Know your blood pressure, cholesterol, fasting glucose or A1c, and know what it means,” Jackson said. “Know that smoking causes heart attacks a decade sooner.”
Piña told Healthline that women should also pay attention to symptoms.
“As women, we may often deprioritize our own health and focus on the health of our children, partners, parents, or loved ones. Women need to continue to put their heart and brain health first,” Piña said.
She said this is where a program such as Go Red for Women is valuable.
“While there are many similarities in the symptoms of heart disease and stroke in men and women, there are even more differences,” Piña said. “Pain in the jaw, nausea, and shortness of breath are heart attack symptoms that somewhat appear more often in women. While most people do not immediately associate these symptoms with a heart attack, it’s important to remember that they could be the initial signs of a major cardiovascular event.”
Experts say there are steps women can take to be proactive about heart health beyond education.
Jackson suggests women reframe how they think about heart health and risk, and how they communicate it with their primary care doctors.
“Learn about it, talk about it, ask about it, and take action about it, not just as a 10-year risk but as a lifetime risk,” she said.
Jackson also suggests some “prescriptions” women can write for themselves right away.
“Eating healthy and exercising really are some of the best ‘medications’ one can use,” said Jackson. “Ample data shows the benefits of these lifestyle adjustments. They don’t replace statins when they are needed, but they are a nice addition that benefits all.”
Piña said the AHA and Go Red for Women are working hard at helping women do all those things and more.
Currently, they’re working on amping up the data and understanding from all heart research with “Research Goes Red.”
This program’s goal is to build the world’s largest longitudinal women’s health study and research marketplace to further shine a light on women’s heart health by closing gender disparity gaps in research and clinical trials.
The mental health angle
The organization is also currently looking into the ties between women’s heart health and mental health.
In particular, they’re examining how the COVID-19 pandemic is impacting women’s mental health in their Women and Worry study, which was launched earlier this month.
Because another “prescription” women can write themselves, Piña said, is a reduction in daily stress.
“Women lead busy, often stressful lives, taking care of their families, working, and remaining connected to their friends and social activities.” Piña said.
“Inadequate sleeping patterns and stress also increase a woman’s risk for heart disease and stroke,” she added. “Too much stress can encourage behaviors that increase your risk, such as eating a poor diet, physical inactivity, and excessive smoking or drinking alcohol. Socioeconomic status may also increase stress and affect access to basic living necessities, medication, doctors, and the ability to adopt healthy lifestyle changes.”
Experts agree that less stress, better diet, more movement, and a basic education about the risks of heart disease over a lifetime may help bridge the male-to-female cardiovascular treatment gap.
“The ‘men’s disease’ view has improved over time,” Jackson said, “but this shows us we can do more.”
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