Vitamin G

Heart Attacks in Women Are Woefully Under-Researched, Says New Report

Thing you probably already knew: Cardiovascular disease (including heart disease, hypertension, and stroke) is the number one killer of women, according to the American Heart Association. It leads to the death of half a million American women a year—that's more than the next seven causes of death combined.

Thing you also probably knew: Women's bodies are not the same as men's bodies. (Duh.) That's true when it comes to cardiovascular disease, too; compared to men, women are 15 percent more likely to die of a heart attack, and twice as likely to have a second heart attack in the six years after the first.

That's why, when the American Heart Association released its first-ever statement on female heart attacks yesterday, our reaction was "...wait, how is this possibly the first—shouldn't there already have been a report specific to women?"

The big take-aways from the new statement: Women's heart attack treatment, causes, and symptoms differ from men's, and we have some major knowledge gaps in how to prevent and treat female cardiovascular events.

"Over the last 10 years or so, we've learned that women's hearts are different than men's in some significant ways, and while that's helped reduce mortality, there's much more to know," Laxmi Mehta, M.D., a cardiologist at the Ohio State University Wexner Medical Center and chair of the committee that produced the statement, said in a release. "Most heart disease research is done in men, so how we categorize it is based on men. We need more science in women."

Yes, yes we do. For now, the statement, published in the American Heart Association's journal Circulation, hits on some highlights of what we do know:

Risk factors: What puts women at risk for heart attacks differs in degree from men's risk factors. For example, the heart disease risk of a young diabetic woman is 4 to 5 times higher than a young man's, and high blood pressure is more strongly linked with heart attacks in women than in men.

Racial differences: In all age groups, black women are more likely to have heart attacks than white women, and black women are less likely to be referred for key treatments (such as cardiac catheterization). On average, black and Hispanic women also have more risk factors, such as diabetes, obesity, and high blood pressure, than white women do at the time of their heart attack.

Causes: OK, this is complicated but important: Both men and women have heart attacks caused by blockages in the main arteries leading to the heart. But the way the blockages form differs in men and women. Women tend to have less-severe blockages that don't require stents (little supports that prop open a blood vessel), but the obstructions manage to damage the arteries, leading to less blood flow to the heart, which leads to, you guessed it, a heart attack. If doctors incorrectly assume a big blockage itself caused the heart attack (a la men's heart attacks), they may prescribe the wrong treatments after the attack.

Symptoms: The most common heart attack symptoms are the same for both sexes: chest pain or discomfort. But women also often have more vague or atypical symptoms, like shortness of breath, back or jaw pain, anxiety, sweating, indigestion and nausea or vomiting. Take heed: A heart attack won't necessary look like the chest-clutching scene you see in daytime soaps.

Treatment: Our blood vessels are smaller than men's, and we tend to have heart attacks later in life and in tandem with other risk factors, such as high blood pressure—all reasons it's harder to restore blood flow to a female heart than a male one, post-heart attack. Then there's the issue that, bewilderingly, we're just not getting the guideline-recommended treatments and medications men are using, the report shows.

"Despite stunning improvements in cardiovascular deaths over the last decade, women still fare worse than men, and heart disease in women remains under-diagnosed and under-treated, especially among African American women," Mehta said. "Women should not be afraid to ask questions—we advise all women to have more open and candid discussions with their doctor about both medication and interventional treatments to prevent and treat a heart attack."

Photos: Getty

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