Heart disease is the number one killer of women—more than all cancers combined. This isn’t new information. In fact, since 1910, we saw this trend. More than that, since 1984, heart disease has killed more women than men. Yet, somehow, while we are seeing cardiovascular mortalities declining, death rate reduction in women has lagged behind men. For women younger than 55 years old who have been previously considered “low risk,” cardiovascular deaths have increased. Since 2004, with the launch of the American Heart Association’s Go Red for Women campaign, guidelines have been written specifically for the prevention of heart disease in women. These guidelines were further updated in 2011. So why, with 80% of heart disease preventable, is there this disconnect? Why isn’t heart disease being prevented in women?
What is the Problem?
A study published in July 2017 in the Journal of the American College of Cardiology entitled “Knowledge, Attitudes, and Beliefs Regarding Cardiovascular Disease in Women,” revealed that a huge part of the problem is the physicians. In a survey of 200 PCPs and 100 cardiologists, only 39% considered cardiovascular disease their greatest concern for their female patients, with weight and breast health perceived as the greatest issues. Only 22% of PCPs felt prepared enough to discuss heart disease with their female patients, and shockingly, only 42% of cardiologists felt prepared to do this! Sadly, in spite of the Evidence-Based Guidelines for the Prevention of Cardiovascular Disease in Women, only 16% of PCPs and 22% of cardiologists implemented the eight American Heart Association guidelines for CVD risk assessment.
This reflects patient feedback. When surveyed, women reported that of the advice they most often received from their doctors, the first was advice to lose weight. Rarely was heart disease risk even mentioned. Also, women were much less likely to receive medication, compared to male patients with the same medical issues. There was no standardization in how the women patients were treated compared to the men.
What is the Solution?
It is time that the medical community looks at their role in this. Women need to be evaluated objectively, with an understanding of their nuances at the forefront of the conversation. Let’s not give up on the power of the doctor-patient relationship. Let’s understand that we can prevent one women dying every 80 seconds, just by changing our strategy. We are failing our women patients by not prioritizing their heart health. A simple assessment of risk factors and a commitment to understanding personal and family history could make all the difference in both prevention and treatment.
These are not impossible tasks. We are already doing this as appropriate for male patients, and the guidelines for women are out there, readily available. It’s time we pay attention to this red-alert. It’s time we closed the gap.