Heart disease in women underestimated

Friday 13th March 2015 - Deborah Condon , View Article Here

Breast cancer is still commonly perceived as a bigger health issue for women than cardiovascular disease (CVD), despite the fact that CVD is the leading cause of death among women in Europe, the European Society of Cardiology (ESC) has said.

According to the society, CVD kills over half of women in Europe, while breast cancer kills just 3%. Furthermore, CVD kills more women than men, but is still considered by many to be a ‘man's disease'.

"CVD is still largely considered a man's problem with breast cancer commonly perceived as the greater issue for women. However, CVD is the top killer of women in Europe, resulting in 51% of deaths compared to 3% caused by breast cancer," noted ESC spokesperson, Dr Susanna Price, a consultant cardiologist based in London.

She pointed out that CVD is the main cause of death among women in every European country, killing 51% of European women compared to 42% of European men.

"Women's risk of heart disease tends to be underestimated by both the public and the medical profession because of the perception that oestrogen protects them. In reality this just delays the onset of CVD by 10 years. The result is that women's risk factors are left untreated, leaving them more vulnerable to heart attack, heart failure and sudden cardiac death when the protection fades after menopause," Dr Price explained.

She said that one of the reasons that CVD is under-recognised and under-treated in women is because they can experience atypical symptoms.

"Instead of chest pain, women having a heart attack may experience nausea/vomiting, shortness of breath, jaw pain, fatigue, palpitations, syncope (fainting) or cardiac arrest," Dr Price noted.

She also pointed out that CVD increases the risk of a stroke and women are more likely than men to be left severely disabled after a stroke. This is partly down to the fact that despite clot-busting drugs known as thrombolysis benefitting women more than men, fewer women receive them.

Dr Price suggested that this is because these drugs are most effective in the three to six hours after stroke symptoms begin and women are less likely than men to get to hospital within this time frame.

Meanwhile, Dr Price also emphasised that there are greater health risks associated with smoking in women because they metabolise nicotine faster, especially if they are also taking the oral contraceptive pill.

"In common with men, women can reduce their risk of CVD by not smoking, being active, having a healthy body weight, getting their blood pressure and cholesterol checked and taking treatment if levels are high," she said.

However, she noted that women can respond differently to treatments because they have a lower body weight, a higher percentage of body fat and different hormone levels. For example, aspirin does not reduce the risk of heart attack in women, but does in men.

"In many cases the safety and effectiveness of treatments in women are unknown because they have been tested mainly in men. Clinical trials are needed that include only women and/or more equal proportions of both sexes," Dr Price added.

For more information on heart disease, see our Heart Disease Clinic here

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