The American Hearth Association (AHA) has released a scientific statement announcing that the cardiac disease mortality rate has been greater for women than for men since 1984. In addition to being more deadly for women, heart attacks have different symptoms than in men, some of which can be vague. The AHA’s statement, its first on gender differences in heart attack patients, was published Jan. 26 in the journal Circulation.
Statement chair person Dr. Laxmi Mehta says that over the last 10 years they have learned that men’s and women’s heart attacks are different in “some significant ways.” Although that has helped reduce mortality, there is much more to learn. She says that, since most heart disease research is done on men, how it is categorized is based on men.
The differences in heart attack symptoms between men and women can lead to deadly mistakes. The AHA said in their statement that, although experts have known about differences for years, the message is not getting through to either women or health professionals.
Heart attacks in both men and women are typically caused by blocked arteries. The difference is in how they form. Women tend to have less severe blockages than men, but those blockages still damage the arteries that supply blood to the heart. When that blood flow is reduced a heart attack can happen.
53,000 women die from heart attacks every year. Twenty-six percent of women die within a year of their first heart attack, compared to 19 percent of men. Within 5 years of a first heart attack, 47 percent of women die or have a stroke or heart failure, compared to 36 percent of men.
Mehta says the reason heart attacks are more deadly for women is that doctors often do not correctly diagnose the underlying cause of a heart attack in a woman, so they do not prescribe the right treatment after the attack occurs. The difference in mortality between the sexes is also due to the woman not realizing her symptoms may be that of a heart attack, because women’s heart attack symptoms are different than men.
The most common symptoms in both men and women are chest pain or discomfort. However, women are more likely to have less typical symptoms, such as nausea, vomiting, shortness of breath, and jaw or back pain. Shoulder and arm pain, typically thought of as heart attack symptoms, are twice as predictive of a heart attack diagnosis in men as in women.
This means women might wait too long to seek help, not realizing they are in trouble. Men usually report to the emergency room within 15 hours of their symptoms starting, while women wait more than two days on average.
Mehta says it is important that women pay more attention to symptoms. She also stresses that more research is needed, since most heart attack information relates to men. “We don’t yet clearly understand why women have different causes and symptoms of heart attacks. Women are more complex, there are more biological variables such as hormonal fluctuations. That’s why more research is needed.”