Revisiting October’s Insights: Women’s Heart Health – Differences?

Cardiovascular disease (CVD) is the leading killer of both women and men in the US. Despite the significant impact CVD has on women, awareness, and education for women’s heart disease have historically been low. 

CVD in women remains underdiagnosed and undertreated due to the diagnostic challenge it presents, as well as the persisting attitude that CVD predominantly affects men. These gender differences have caused widespread concerns and the consideration of gender differences is of great importance for the prevention, diagnosis, treatment and management of CVD. Early detection and management of CV risk factors and CVD remain paramount for improving women’s cardiovascular health and reducing premature mortality.

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Martha Gulati: We know women are less likely to receive guideline-directed medical therapy. Using the example of acute myocardial infarction, women are less likely to go to the cathlab, and they have longer times, so door-to-balloon times are definitely longer for women compared to men. If you use thrombolytics — we know that thrombolytics are less likely to be given to women, but again, door-to-needle time is longer for women compared to men. We know guideline-directed medical therapy is less likely to be given to women. Whether it’s within the first 24 hours or upon discharge, we don’t somehow treat women the same. And as a result, we see greater readmission in women, and we know over time that these trends have persisted. So, it should be of no surprise to any of us that women are more likely to die after myocardial infarction, particularly in the ST elevation myocardial infarction group. And what’s even more disturbing is that mortality is highest in the youngest women. Those under the age of 55 are more likely to die, and we have not made great strides in the younger group in the way that we’ve seen reductions in mortality in younger men, or even older men and women. And we also know that this is a global problem.