The Current Picture
Cardiovascular disease (CVD) is the leading cause of mortality amongst women in the UK, responsible for the deaths of 1 in 14 women.
There is a common misconception that CVD is a ‘man’s disease’. This is an image that is hardly helped by the stereotypical image of a middle aged man clutching his chest as he groans, commonly seen on TV dramas.
Results from the 2012-2017 Health Survey for England found that women do not experience the ‘traditional’ CVD risk factors that men of a comparable age exhibit. Whilst hypertension and smoking is seen at a lower prevalence than men, obesity rates are higher in women.
The Unique Risks Experienced By Women
Aside from not experiencing the ‘traditional’ CVD risk factors, women also experience a unique set of risk factors that set them apart from their male counterparts.
The hormonal fluctuations experienced during menopause can impact cardiovascular health. Lower oestrogen levels can lead to more systemic inflammation and increase susceptibility to Takotsubo cardiomyopathy (commonly known as ‘broken heart syndrome’).
Pregnancy can also come with its own risk factors. Pre-eclampsia, gestational diabetes and peripartum cardiomyopathy are also associated with cardiovascular risk both immediately and in the long term.
Women and Coronary Artery Disease
Women tend to present at an older age with more comorbidities than the male cohort at the same age and with a higher burden of angina yet are less likely to be referred for diagnostic assessment.
Women and Heart Failure
Women present with heart failure symptoms at a later age than the equivalent male population with less ischaemic aetiology but more comorbidities such as hypertension, atrial fibrillation and obesity.Furthermore, the normal ejection fraction range is higher in women but these physiological differences are not taken into account within diagnostic guidelines.
Women and Arrhythmias
Electrocardiographic differences can be observed between female and male ECGs. Women have marginally narrower QRS complexes as well as slower baseline heart rates.
Pre-menopausal women have longer corrected QT intervals (QTc) than men of the same age thus putting them at a greater risk of developing acquired long QT syndrome.
Symptom severity also presents differently between men and women with women having fewer clinical symptoms that have a later onset than men.This in turn leads to women not receiving the same level of appropriate treatment as men as well as longer diagnostic delays.
How Can Healthcare Change This?
Challenging the disparities faced by women can be achieved by:
- Busting the myths surrounding CVD. CVD is not just for men.
- Educating healthcare professionals and female patients to recognise CVD symptoms.
- Spreading awareness of the disparities faced by women.
- Implementing women’s health screenings.
By reading this blog post, you have already achieved points 1 and 3!
If you’re looking to offer women’s health screenings, why not get in touch with a member of our team to find out how we can help!
Reference:
https://heart.bmj.com/content/110/22/e3