Years after experts began raising flags about gaps in prevention and care for women with heart disease, women continue to be under-researched, under-treated and often under-informed compared to men.
Researchers at the University of Ottawa Heart Institute are hoping to create a network to improve cardiovascular disease prevention and care in women to close some of those gaps.
“We are doing better than we used to, but there are still gaps,” said Dr. Kerri-Anne Mullen, who is program director at the Canadian Women’s Heart Health Center at the Heart Institute. She is co-leading the new cardiovascular disease prevention network, which was created with up to $1.2 million in combined funding from the Public Health Agency of Canada and the Heart Institute’s foundation.
Unlike highly coordinated screening programs for some cancers, there are no similar programs for heart disease, which is more fatal for both men and women. Close to five times as many women die from cardiovascular disease in Canada each year than breast cancer, according to the Canadian Women’s Heart Health Centre.
Cardiovascular disease is the leading cause of death in women over 35 around the world, accounting for more deaths every year than all cancers combined, according to the women’s heart health center.
Mullen said the network will target women who are at higher risk of cardiovascular disease. That includes women who have blood pressure-related pregnancy complications and higher risk populations, including Indigenous women and South Asian women.
“The cancer system does a really great job of screening. We don’t have the same type of systemic screening when it comes to cardiovascular disease.”
Not only are there female-specific risk factors for cardiovascular disease — such as pregnancy complications — but women often present differently when they are having heart attacks.
Mullen said one of the aims of the network will be to make sure the symptoms that are more common in women are recognized.
Men and women both have chest pain, but women often describe it differently, as a burning in the chest compared to a crushing pain, said Mullen. Women are also more likely to report a number of symptoms such as jaw pain, excessive sweating and indigestion.
Mullen said he still hears anecdotally of women being turned away multiple times when they show up at emergency departments or clinics with symptoms of a heart attack. Women also continue to be diagnosed with anxiety when they present with potential heart attack symptoms, she said.
“There is still work to be done,” she said. “The reality is that heart disease for so long has been called a man’s disease.”
In fact, heart disease is declining among men but growing among women. Younger women receive some protection from estrogen, but when they go through menopause, their risk of heart disease goes up.
Mullen said a thorough screening program could help identify who is at greatest risk of developing heart disease early for better preventative treatment.
Better awareness among women would also make a difference, said Dr. Thais Coutinho, who heads the Heart Institute’s division of cardiac prevention and rehabilitation and chairs the Canadian Women’s Heart Health Centre.
“Any steps toward closing the gaps to ensure women are as well-informed and well cared for as men is a giant leap forward,” she said.
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