Better Health. No Hassles. Megan McCarren and Valerie Hacker Pacific Lutheran University November 2007 Women and Heart Disease

Better Health. No Hassles. What is a Heart Attack?

Better Health. No Hassles. Source: AHA Heart and Stroke Statistical Update, 2003  Since 1984, the number of deaths for women has exceeded those for males. Heart Disease Is Not Just A Man’s Disease

Better Health. No Hassles.  More women in every age group die from heart disease than breast cancer  One in two women will die of heart disease (breast cancer is one in ten)  Two-thirds of women who die from a heart attack, have no previous symptoms of the disease  Women die twice as often after a heart attack as compared to men More Facts

Better Health. No Hassles.  Most of the research on heart disease has been done on men.  Physiological differences between men and women leading up to a heart attack  Symptoms are different between men and women  Problem of awareness and perception Why do Gender Differences Exist?

Better Health. No Hassles.  Anatomy: Smaller heart arteries  Physiology: Estrogen has a protective effect in women  Pathology: Less likely to have total blockage of heart arteries How are Women Different?

Better Health. No Hassles.  Cholesterol Level- High cholesterol more common in older women than men  Blood Pressure– Pregnancy and some BCPs can increase risk of high blood pressure  Diabetes- Increases heart disease risk in women up to 7 times (men up to 3 times)  Smoking- Combination of smoking and BCPs increases risk  Age- women experience symptoms 10 years later  Physical inactivity- osteoporosis and other age-related conditions may limit ability to exercise Are there Differences in Risk Factors?

Better Health. No Hassles.  Women may have “typical” or “atypical” symptoms typical: crushing chest pain traveling down the left arm, nausea atypical: shortness of breath, abdominal pain indigestion, fatigue  Atypical symptoms lead to delays in treatment because the symptoms are vague and associated with other medical conditions  Delayed treatment often means poorer outcomes How are Women’s Symptoms Different?

Better Health. No Hassles.  Women will show up one hour later to the Emergency Room, as compared to men  Women are less likely to complain of “heart attack” symptoms  Women will continue activities when feeling ill  The bottom line: women are less likely to seek rapid and appropriate care when their symptoms start. This causes significant delays in treatment. Denial is Part of the Problem

Better Health. No Hassles.  Compared to men, women are: -7% less likely to receive clot dissolving drugs during the first hour of heart attack treatment -6% less likely to receive aspirin within the first 24 hours of hospital care -More likely to receive a “do not resuscitate” order  Some diagnostic tests and procedures, including the exercise stress tests, are less accurate in women. Are There Gender Differences in Care?

Better Health. No Hassles.  Need more gender-specific research and development of clinical guidelines  Women need to demand that there be more gender specific care  Need more gender-specific diagnostic testing (example: 80 lead EKG) What is Needed to Bridge the Gender Gap?