No disease on Earth has a bias towards men or women and cardio vascular diseases are no different. CVD affects men and women equally however women continue to be underrepresented in research for CVD and hence there are huge gaps in knowledge and understanding of how CVD impacts women.
Some risk factors for heart disease are specific to women, such as risks related to menopause and treatments for breast cancer, and some, such as depression, carry a different risk for cardiovascular disease events in women than in men. Understanding the genetic, cellular and physiologic factors affecting women’s heart health is necessary to achieve health equity.
Comparing health data from women to data from men may lead to conclusions that men’s health is the ”gold standard“ and women’s health is “atypical.” This overlooks the unique biology and life stages of women that impact their health.
According to a new Presidential Advisory from the American Heart Association, published today in the Association’s flagship journal Circulation there is a need to identify and remove barriers to health care access, quality and equity for women.
The advisory outlines an actionable roadmap, divided into four key areas that require attention and investment to better address women’s heart health: 1) epidemiology and prevention; 2) awareness; 3) access and delivery of equitable health care; and 4) involvement of health care professionals, researchers and communities.
Advocacy and educational campaigns focused on heart disease made great strides in improving knowledge and attitudes among women between 2004 and 2009: awareness of heart disease as the leading cause of death among women jumped from 30% to 56%. However, awareness has slipped, with 44% of women identifying heart disease as their leading cause of death in 2019. Declines in awareness were highest among young women (ages 25-34) and among those who identified themselves as Black or Hispanic.
To combat these falling numbers, the advisory committee suggests increasing education for health care professionals. Nearly 7 out of 10 post-graduate medical trainees reported minimal to no training regarding gender-based medical concepts, and only 22% of physicians and 42% of cardiologists feel prepared to adequately assess heart disease specific to women.
The advisory urges:
- Creating and implementing heart health-awareness campaigns that are culturally sensitive and appropriate, and emphasize the benefits of prevention and education;
- Optimizing prevention and clinical care through partnerships among cardiology, other specialties such as obstetrics/gynecology and primary care to improve the recognition of heart disease risk factors and ensure tools to calculate risk incorporate factors specific to women;
- Increasing the number of research studies focused on women, especially women from diverse racial and ethnic backgrounds and at younger ages;
- Engaging communities in heart health programs, some beginning in the primary school years, to engage girls and parents and empower families;
- Encouraging advocacy for public policy and legislative interventions that address social determinants of health, which may include access to healthy food, public spaces for physical activity and high-quality prevention and treatment; and
- Surveying and monitoring disease and risk factor data to better capture information that is critical to improving prevention and outcomes and delivering more effective health care.