HIDDEN EPIDEMIC

Women are the majority of health consumers in Australia.

Women are the majority of health service care providers in Australia.

Women are the the majority of carers in Australia.

It is a common belief that women are better at looking after their health than men.

Yet more women than men die of heart disease.

It is the number one killer of women.

Each year one in three women die of heart disease.

This hidden epidemic receives far less attention than breast and gynaecological cancers.

Women are almost three times more likely to die of heart disease than breast cancer.

So why don’t women look after their cardiac health better?

Women often put the needs of others before themselves.

They are less likely to attend cardiac rehabilitation, less likely to take their medication regularly, and are less likely to make the lifestyle changes necessary for improving and maintaining good health.

Cardiovascular disease does not affect women in the same way that it affects men.

And it is therefore overlooked.

Unlike men, women do not experience the typical symptoms of a heart attack like men and may attribute their symptoms to other causes.

With catastrophic consequences.

40% of women did not experience chest pains when having their heart attack.

What are the typical symptoms of a women who is having a heart attack? 

    1.    Discomfort or pain in the chest – often described as ” elephant sitting on chest”, “a belt this is tightened”, or”bad indigestion”.

    2.    Discomfort in arms, shoulders, neck, jaw or back.

    3.    Shortness of breath

    4.    Nausea

    5.    Cold sweat

    6.    Dizzy or light headed.

    7.    A feeling of generally unwell or “not quite right”

Some people may experience one symptom while others may experience a combination.

If there is a symptom for more than 10 minutes, call an ambulance.

Any delay in heart attack treatment worsens the outcome.

Every hour, one women dies of a heart attack in Australia.

Despite the number of women living with cardiovascular disease and stroke exceeding men, fewer diagnostic and therapeutic procedures for cardiovascular disease are performed on women than men.

The risk factors for women were 

i.High cholesterol

ii. High rates of being overweight and obese.

iii. High rates of physical inactivity

iv. Smoking

v. Poorly controlled diabetes

iv. Depression 

Heart disease can occur at any age.

But the risk for women increases significantly around menopause.

It is not at all clear why women get heart disease later than men.

One explanation put forward is that the drop in women’s oestrogen levels may have an impact as well as other changes that occur around menopause.

Hormone Replacement therapy, which includes oestrogen replacement, is used to treat short term menopausal symptoms. The Heart Foundation does not recommend HRT in the treatment or prevention of health disease.

Women who take oral contraceptives AND smoke also greatly increase the risk of heart disease, stroke and blood clots in their legs and lungs.

Finally, research into heart disease has a “gender gap”.

Despite the difference between heart disease in men and women, there is research into heart disease that only looked at men.

Only 75% of research articles that established clinical recommendations included women.

And inferences about treatments had to made where trials included only men.

Researchers at Brigham and Women’s Hospital in Boston, USA looked at this issue and concluded that

“The science that informs medicine – including the prevention, diagnosis, and treatment of disease – routinely fails to consider the crucial impact of sex and gender. This happens in the earliest stages of research, when females are excluded from animal and human studies or the sex of the animals isn’t stated in the published results. Once clinical trials begin, researchers frequently do not enroll adequate numbers of women or, when they do, fail to analyze or report data separately by sex. This hampers our ability to identify important differences that could benefit the health of all.”

To learn more about the hidden epidemic:

Heart Attack Warning Signs

Mosca, Lori, Elizabeth Barrett-Connor, and Nanette Kass Wenger. “Sex/gender differences in cardiovascular disease prevention.” Circulation 124.19 (2011): 2145-2154.

Sex-Specific Medical Research. Why Women’s Health Can’t Wait

Women and heart disease, Australian Institute of Health and Welfare