As women actresses walked the red carpet at the Golden Globe awards dressed in black to corroborate and validate the #MeToo movement, I was touched by the notion that women are increasingly standing up for each other and coming together for the betterment of all women’s lives. As this consolidation of purpose is occurring, I can’t help thinking that we can do even more. What about the fact that heart disease continues to be the number one killer of all women, with statistics continuing to reveal that when women present with symptoms related to heart disease, they are under-diagnosed, provided with less treatment, and have significantly worse outcomes compared to men? How can we continue to ignore this most critical woman’s issue? As long as we are standing up for women, shouldn’t there be a movement as powerful and significant as #metoo, that could shed light on the fact that more women are dying of heart disease than from any other cause, and that this is largely preventable? I believe doctors must get on board with this issue, so let’s look at the cold hard facts.
When reviewing the major trials on women and heart disease, it is clear that the paradigm of women and heart disease has to change. The WISE trial, which elucidated how chest pain in women can be associated with non-obstructive coronary artery disease, was the first significant research to demonstrate microvascular disease in women. Of course, the Prevention Guidelines, last written in 2011, showed the profound impact of hypertension, diabetes, and depression on women’s hearts and explained pregnancy as a “metabolic stress test.” We have the American Heart Association Stroke Guidelines, published in 2014, Stroke Guidelines for Women, showing that pregnancy, hormones, and migraines all contribute to the risk of stroke. Lastly, the American Heart Association Scientific Statement from 2016 about Acute Myocardial Infarction in Women, shed light on how women are less frequently referred to lifesaving treatment and are less likely to be prescribed medication that will prevent complications, improve quality of life, and offer secondary prevention of MI.
Turn the Focus to Prevention
In spite of these guidelines and recommendations, and the progress made in research, we are still seeing more women dying of heart disease, more than all cancers combined. When outcomes in women with heart disease are worse, I propose we focus on the preventive aspects and women’s heart health, so we can truly combat these statistics and provide strategies for early detection of disease, before there are clinical manifestations.
We can beat the number one killer of all women—by diagnosing earlier in the disease process and implementing lifestyle changes and medications to prevent progression. This is the time, as we are already coming together on so many other women’s issues. It’s time to set aside opinions, old ways, and focus on preventive strategies. Let’s get on board with a new direction with aggressive screening. Let’s take the momentum we have supporting women’s issues and understand women and heart disease needs to be a priority. After all, our mission is to save lives.