Women Do Get Cardiovascular Disease!

woman weight trains on beach

Physicians are on the verge of practicing personalized medicine. No more shotgun therapy; we will soon be able to identify and target individual-specific diseases and even discern the tendency to develop particular diseases. Yet, while we bask in our soon-to-be success, we cannot neglect the primary way to distinguish and differentiate our patients — gender.

When it comes to heart disease somehow most doctors and laypeople still believe that women are immune to this ailment. Perhaps more misleading, many expect women’s’ experience of cardiovascular disease to precisely parallel that of men. Both suppositions are blatantly wrong.

First, women have an extraordinarily high rate of cardiovascular disease (CVD); annually more women than men die from this spectrum of disorders. The illusion that women are somehow immune to heart attacks and strokes has led to under-recognition and concomitant under-treatment of not only the risk factors causing CVD, but even heart attacks and strokes as well.  Thus, women often die from heart attacks and strokes when they could have been saved. Ignorance may be bliss under some circumstances, but certainly not when it comes to our health.

woman on beachThen there are the assorted gender-based differences in the “experience” of CVD. Women have more angina than men, but they also have more atypical symptoms, shortness of breath being the most common. Women, with mild coronary plaques have a prognosis far worse than that of men with similar anatomy. Women have more diastolic heart failure than men (heart failure in the setting of a strong but stiff heart muscle). Women have many more complications than men when being treated for heart disease, bleeding being the most common. Implausible as it may seem, I could go on for some time differentiating men and women in relation to CVD. These manifold differences are so important that in 2011 the American Heart Association changed doctors’ approach to risk stratifying women for CVD, but not men. And, important organizations such as WomenHeart and the Society for Women’s Health Research were created for the sole purpose of improving women’s cardiovascular care.

The take-home message here is simple. We all know that men and women are different. It should therefore not be an intellectual leap to grasp that gender differences extend into health and disease. As CVD kills more women than any other ailment we must put ourselves on high alert for any suggestion of risks or events. All of us have women we love in our lives. Let’s do our best to keep them healthy and free of cardiovascular disease.

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