Heart-stopping truths about heart disease in women

Women: different symptoms, different prognosis

Heart disease is the no 2 killer in Israel with more than 5000 women dying from heart disease, stroke and other vascular disease in 2017 1 2

Heart attacks are responsible for more deaths in women than men, but women are receiving diagnosis and treatment later than men!

It takes the average woman in Israel 59 minutes longer to turn for help than a man while having a heart attack—and 89 minutes longer than a man to get to the ER. 2

A recent Israeli study showed that despite advanced treatments available 1 year mortality from heart attacks has not changed in 2 decades for women! Clearly something has to change to improve outcomes

. 3 , 4

Women need to be given the tools and education to know when they need to ask for help, and the right help too. It’s time for our health to be managed equally.

Three Heart-stopping truths

1. no. 2 killer

In Israel, cardiovascular disease (CVD) is the no. 2 killer after cancer. 1

In 2017, approximately 3700 women died in Israel from heart disease, and more than 5000 if stroke and other vascular disease are included. 2

Heart disease in women is often under-recognized and under-treated because women can have different or atypical symptoms. 3

According to the Centres for Disease Control and Prevention (CDC), just 54 % of women recognise that heart disease is their greatest threat. Create Relevant Content

2. Late presentation - Time is myocardium

It takes the average woman in Israel 59 minutes longer to turn for help than a man while having a heart attack—and 89 minutes longer than a man to get to the ER. 2

Heart attacks are responsible for more deaths in women than men, but women are receiving diagnosis and treatment later than men! 5, 6

Since 2010, the decline in cardiovascular mortality has plateaued and remained nearly unchanged. A study conducted by an Israeli Women’s Heart Center Cardiologist, Dr Avital Porter showed that despite better treatments being available to women in Israel, the 1- year mortality of women has remained unchanged for the past 2 decades (from 2000-2016). The lack of reduction in mortality rates among women over time suggests that more measures should be provid

ed in this high-risk population. 5 .

3. Exposing Gender bias in heart health

Only 35 % of participants in heart-related studies are women, and nearly 75 % of cardiovascular clinical trials do not report sex-specific results. This despite the fact that the cardiovascular health of women is strongly affected by sex-specific factors, including hormonal and metabolic disorders, pregnancy-related adverse CV outcomes, menopausal status, and associated autoimmune diseases. 7 Using research that is skewed to male physiology and biology puts women at risk for incorrect diagnoses, misinformed treatments, illness, and even death. 4

Women need to be given the tools and education to know when they need to ask for help, and have access to the right help too. It’s time for our health to be managed equally.

References:

1. Israel Ministry of Health. CVD statistics Available from: https://www.health.gov.il/English/MinistryUnits/ICDC/Chronic_Diseases/Heart_diseases/Pages/default.aspx Accessed August 12 2020

2. The Heart of the Matter. Dr Donna Zwas. Available from: https://blogs.timesofisrael.com/the-heart-of-the-matter-2/ Accessed August 12 2020.

3. European Society of Cardiology (ESC). Cardiovascular disease kills 51% of women in Europe and breast cancer kills 3%. Available from: https://www.escardio.org/The-ESC/Press-Office/Press-releases/Cardiovascular-disease-kills-51-of-women-in-Europe-and-breast-cancer-kills-3 Accessed August 12 2020

4. Haywood T. Not Just A Man’s Problem: The Deadly Cost Of Underestimating Women’s Heart Disease. A

vailable from: https://www.healthaffairs.org/do/10.1377/hblog20150929.050875/full/ Accessed August 12 2020

5. Porter A, Paradkar A, Goldenberg I, Shlomo N, Cohne T, Kornowski R, et al. Temporal Trends Analysis of the Characteristics, Management, and Outcomes of Women With Acute Coronary Syndrome (ACS): ACS Israeli Survey Registry 2000-2016. J Am Heart Assoc. 2020;9:e014721. DOI: 10.1161/JAHA.119.014721.

6. Huded C, Johnson M, Kravitz K, Menon V, Abdallah M, Gullet TC, et al. 4-Step Protocol for Disparities in STEMI Care and Outcomes in Women. J Am Coll Cardiol 2018; 71:2122–2132. doi: 10.1016/j.jacc.2018.02.039.

7. Garcia M, Miller VM, Gulati M, Hayes SN, Wenger NK, Merz CNB, et al. Focused Cardiovascular Care for Women: The Need and Role in Clinical Practice. Mayo Clin Proc 2016;91(2):226-240. DOI: 10.1016/j.mayocp.2015.11.001