Women and Heart Disease

1
Women and Heart Disease
Megan McCarren and Valerie HackerPacific
Lutheran UniversityNovember 2007
2
What is a Heart Attack?
3
Heart Disease Is Not Just A Mans Disease

• Since 1984, the number of deaths for women has
  exceeded those for males.

Source AHA Heart and Stroke Statistical Update,
2003
4
More facts

• More women in every age group die from heart
  disease than breast cancer
• One in two women will die of heart disease
  (breast cancer is one in ten)
• Two-thirds of women who die from a heart attack,
  have no previous symptoms of the disease
• Women die twice as often after a heart attack as
  compared to men

5
Why do gender differences exist?

• Most of the research on heart disease has been
  done on men.
• Physiological differences between men and women
  leading up to a heart attack
• Symptoms are different between men and women
• Problem of awareness and perception

6
How are women different?

• Anatomy Smaller heart arteries
• Physiology Estrogen has a protective effect in
  women
• PathologyLess likely to have total blockage of
  heart arteries

7
Are there differences in risk factors?

• Cholesterol Level- High cholesterol more common
  in older women than men
• Blood Pressure Pregnancy and some BCPs can
  increase risk of high blood pressure
• Diabetes- Increases heart disease risk in women
  up to 7 times (men up to 3 times)
• Smoking- Combination of smoking and BCPs
  increases risk
• Age- women experience symptoms 10 years later
• Physical inactivity- osteoporosis and other
  age-related conditions may limit ability to
  exercise

8
How are womens symptoms different?

• Women may have typical or atypical symptoms
  typical crushing chest pain traveling down
  the left arm, nausea atypical shortness of
  breath, abdominal pain, indigestion, fatigue
• Atypical symptoms lead to delays in treatment
  because the symptoms are vague and associated
  with other medical conditions
• Delayed treatment often means poorer outcomes

9
Denial is Part of the Problem

• Women will show up one hour later to the
  Emergency Room, as compared to men
• Women are less likely to complain of heart
  attack symptoms
• Women will continue activities when feeling ill
• The bottom line women are less likely to seek
  rapid and appropriate care when their symptoms
  start. This causes significant delays in
  treatment.

10
Are There Gender Differences in Care?

• Compared to men, women are-7 less likely to
  receive clot dissolving drugs during the first
  hour of heart attack treatment-6 less likely to
  receive aspirin within the first 24 hours of
  hospital care-More likely to receive a do not
  resuscitate order
• Some diagnostic tests and procedures, including
  the exercise stress tests, are less accurate in
  women.

11
What is Needed to Bridge the Gender Gap?

• Need more gender-specific research and
  development of clinical guidelines
• Women need to demand that there be more gender
  specific care
• Need more gender-specific diagnostic testing
  (example 80 lead EKG)