Are women undertreated for heart disease?

The incidence of cardiovascular disease (CVD) in the United States outranks all other causes of morbidity and mortality. However, the perception still persists that CVD affects primarily men, and that women are somehow protected from it. The reality is a little more sobering. Nearly half a million women in the United States die from CVD every year, and in the year 2000, 41% of all female deaths were attributed to CVD.

One in three women over the age of 65 has clinical evidence of coronary heart disease. Heart attacks, for a number of reasons, also appear to be more lethal in women. While 25% of men will die within one year following a heart attack, that number rises to 40% in women. Overall, heart attacks are responsible for the death of more than a quarter of a million women annually, more than six times the number who die from breast cancer.

Despite the prevalence of heart disease, numerous studies and surveys reveal that many women underestimate their risk for heart disease and overestimate their risk for cancer. They mistakenly see cancer—and in particular, breast cancer—as their biggest health risk. When asked in a 2002 survey commissioned by the Society for Women's Health Research which disease they feared most, the No. 1 response was breast cancer. Only 6% of respondents even mentioned heart disease as a health concern, although more American women die from coronary artery disease alone, than from all types of cancer combined.

There has been a significant rise in heart disease in women and it's a multifaceted issue, according to Emma Meagher, M.D., associate director, Cardiovascular Risk Intervention Program at the University of Pennsylvania Health System. "There's no question that the incidence of heart disease in women has grown disproportionately to that in men," she said. "And while death from CVD has been declining for both genders, the decrease has been far less for women."

Cancer awareness is the result of successful public education and campaigns geared specifically toward women. The media response has been tremendous, but unfortunately, the same has not held true for CVD. Unlike breast cancer, there are no pink ribbons, no 4K runs, and few celebrities lending their name to advertisements and campaigns. Efforts are now being made by the American Heart Association (AHA) and other groups to drum up awareness, but most women still do not perceive heart disease as being a substantial health concern and are not well informed about their risk.

Recent studies also suggest that primary care physicians may not be discussing the risks of CVD with their female patients. In one survey of more than 1,000 women, less than 30% said that their physicians had ever discussed heart disease with them during the course of an office visit. Results also showed that the younger a woman was, the less likely heart disease would be discussed, and 90% reported that they would like to discuss heart disease or risk reduction with their physicians.

A previous survey, conducted among 1,002 women by researchers from Columbia University College of Physicians & Surgeons and published in the Journal of Women's Health in April 1997, found that more than 45% of women 60 years or older also reported that they had not discussed heart disease with their physicians. Data analyzed from the Centers for Disease Control & Prevention's National Ambulatory Medical Care Survey showed that in nearly 30,000 routine visits to physicians, only a minor proportion of women were counseled about physical activity, diet, and weight reduction—lifestyle modifications that reduce CVD risk factors.

Internal server error