Written by Assistant Litigation Executive, Jennifer Corcoran
The British Heart Foundation (BHF) has recently published startling statistics confirming that women are dying from preventable coronary and cardiac complaints.
The statistics show twice as many women die from heart disease as breast cancer, and yet there is a perception that it is a male disease.
Bias and Biology
The BHF funded a research programme that sought to examine diagnosis, treatment and aftercare. They entitled their findings “bias and biology”
Dr Sonya Babu-Narayan, Associate Medical Director at BHF commented that whilst advances in research mean 70% of people survive a heart attack (a reversal of statistics from the 1960s), the odds are stacked against women.
As a result of this, there is a perception that men soldier on in silence.
It is certainly true that a reluctance to disclose or demonstrate a perceived weakness is a disadvantage to men, particularly in fields such as mental health. So, why are more women dying of heart attacks?
Heart Disease is known as either Coronary Heart Disease or Ischaemic Heart Disease.
It occurs when the coronary artery becomes inefficient when fatty deposits build up. This in turn causes iscahemia, or a lack of blood flow to the heart and therefore less oxygen reaches it.
If a full blockage occurs or an arterty ruptures, the heart is starved of oxygen and sustains damage; this is called a heart attack, or a myocardial infarction [myocardium being the heart muscle and infarction coming from the Latin “infarcire” meaning to plug up or cram].
Rapid diagnosis and treatment is vital to treat the person and limit damage to this vital organ.
Angina is an ongoing condition when a person with coronary heart disease experiences pain when they work hard or exercise due to narrow and blocked arteries. An attack can also be triggered by stress and emotions. It does not automatically lead to a full heart attack and the damage to the heart is not thought to be permanent.
Anyone can have a heart complaint. For example, the BHF study suggests that one of the reasons women delay seeking treatment is underestimating the risk and, in some cases, believing they are too young.
Consequently, factors we know to contribute towards the risk of having a heart attack include:
- Family History.
- blood pressure.
- High cholesterol.
- Lifestyle factors such as smoking/obesity.
Another factor that adds strain to the heart that is unique to women is pregnancy. During pregnancy there is additional pressure on the heart and circulatory system as well as changes to the body processing fat and sugar. Moreover, gestational complications such as diabetes, pre-eclampsia or multiple pregnancies can increase risk. Cardiology Professor Mamas A Mamas suggests that women should be monitored in the decades following pregnancy to monitor heart health and identify risk factors sooner.
Above all, whilst you cannot eliminate family history, there are things you can do to mitigate your risk:
- Not smoking
- Maintaining a low-fat diet and exercising to reduce high blood pressure and cholesterol.
- Preventing or managing diabetes well via lifestyle and medication.
- Exercising to keep the heart strong.
- Managing stress.
It is impossible to eliminate all risks, but spotting the symptoms and seeking urgent treatment can limit the damage.
Firstly, symptoms of a heart attack are:
- Chest pressure/tightening that comes on suddenly and does not go away.
- Pain running down the left arm, both arms, or to the neck and jaw.
- Feeling sick, sweaty, light-headed or short of breath.
However, not all heart attacks present in the same way. It is therefore important to know what is normal for you and to seek help if you are concerned.
The BHF study proves that if you are incorrectly diagnosed then you are 70% more likely to die in the 30 days following a heart attack.
Above all, women are 50% more likely to be misdiagnosed than men.
For example, professionals can detect a heart attack using an echocardiograph (ECG) that measures the heart’s rhythm and electrical activity and identifies any irregularities.
In addition, an angiogram, (a test where professionals inject dye into the bloodstream) captures the vessels like an x-ray to identify blockages.
Consequently, these methods rely on availability of equipment and specialism of operator. However, a simple blood test can now detect a protein called troponin, a release from the heart. This can indicate the need for assessment and treatment.
Prompt and appropriate treatment is vital for a good outcome.
Where some receive medication, others have a stent fitted to inflate the artery. In some cases, bypass surgery happens to graft unhealthy arteries onto healthier arteries and promote blood flow.
The BHF research has shown that women are less likely to be prescribed medication and less likely to be referred for an angiogram; this means that their risk of subsequent (and more severe) heart attacks are increased.
Following a heart attack, patients may need support to understand what has happened and manage risks moving forward.
Monitor blood pressure and cholesterol. Also, health professionals can offer cardiac rehabilitation and medication where appropriate.
Women are less likely to be prescribed statins and beta blockers, and at this time we are not sure why this is.
The medical professionals are sure to try to manage this gender gap in care, but to bridge this we need to raise public awareness, understand and tackle inequality, and fund research.
In conclusion, what can women do to help themselves?
- Talk to one another, raise awareness.
- Review their risks and discuss these with their doctor.
- Manage risks, seeking help where needed.
- Learn the symptoms and seek urgent medical assistance if you are at all concerned.
- If you suffer from a cardiac condition, or a heart attack, take the time to recover and discuss prevention strategies with your care providers.
Read the full briefing here: