Research shows that the difference between women and men when it comes to heart health are often under-recognized, placing women at increased risk. In response, Beth Israel Deaconess Medical Center (BIDMC) has launched the Women's Cardiovascular Health Program. The program is part of the CardioVascular Institute (CVI) at BIDMC.
Program services, provided by a growing team of cardiologists at BIDMC in Boston and additional offices in Needham and Chelsea, include the following:
- Evaluation and management of cardiovascular risk factors in women
- Treatment of heart disease in women, including coronary artery disease,
- cardiomyopathies, valvular heart disease, and arrhythmias
- Pre-pregnancy risk evaluation and care of pregnant women with cardiac disease
- Cardiovascular disease resulting from cancer treatment
Comprehensive Program Needed
"For too long, there has been a perception that heart disease is primarily an older man's disease," says Loryn S. Feinberg, MD, medical director, Women's Cardiovascular Health Program. "But women have a higher incidence of cardiovascular disease than do men once they reach the age of 65, and they're more likely to die of cardiac disease than men."
According to Mark Josephson, MD, chief of the Division of Cardiovascular Medicine at BIDMC, "Our cardiovascular specialists have addressed women's heart needs for some time, but it has become clear that women should have more comprehensive, specialized care, which is now offered through our new program."
While the mortality rate in men due to heart disease has been steadily declining over the past two decades, it has increased slightly for women during this time, Dr. Feinberg says. In fact, the latest research shows that a woman dies of heart disease almost every minute in the United States.
A recent report from the American Heart Association (AHA), published in the journal Circulation, shows that American women have upped their caloric intake by 22% during the last three decades. Two-thirds of adult women are overweight, which puts extra stress on the heart.
Studies Show Unawareness and Gender Bias
Additional AHA research has found that only 21% of women are aware that cardiovascular disease is the number-one killer of women in the nation. Also, 46% of women perceive that breast cancer is their most serious health threat, with only 4% citing heart disease.* Nearly 500,000 American women are expected to die this year from cardiovascular disease--nearly double the deaths caused by all types of cancer combined.
Surprisingly, the lack of awareness extends to physicians, according to Dr. Josephson. "Many women are not being properly diagnosed and treated," he says, "and as a result, women may be at greater risk than men. Even doctors may attribute chest pains in women to non-cardiac issues, leading to misinterpretation of their condition."
He adds that women often don't recognize symptoms of coronary artery disease-including abdominal pain, difficulty breathing, nausea, and fatigue-that are different from the classic male heart-attack symptom of chest pain. He warns that this can lead to incorrect diagnoses like indigestion, gall bladder disease, or anxiety attacks.
"Unfortunately, gender bias may still play an insidious role in influencing physicians' decisions," says Dr. Josephson.
A national survey of physicians conducted by the AHA found that almost two-thirds of respondents were unaware of gender differences in the symptoms, warning signs, and tests used to diagnose heart disease. Only 8% of primary care physicians and 17% of cardiologists knew that heart disease kills more women than men.**
Toward Healthier Hearts for Women
According to Dr. Feinberg, the medical establishment needs to recognize fundamental differences between men and women regarding their cardiovascular health, including the fact that women have a smaller hearts and arteries than men. This can lead to more complications for women when they undergo procedures.
Education is key to healthier hearts, she advises: "Women need to be vigilant and proactive. If you think your doctor has missed something, ask for a second opinion, do research, and prepare questions for your physician to answer."
The Women's Cardiovascular Health Program promotes heart health by educating patients about the need for lifestyle changes, including weight control, diet, exercise, and smoking cessation. Program faculty includes seven female cardiologists and four men with specific expertise or research interests in women's cardiovascular issues.
The CardioVascular Institute chose to launch the Women's Cardiovascular Health Program as part of its effort to educate all patients about cardiac health issues during Heart Month in February.
*Twelve-Year Follow-Up of American Women's Awareness of Cardiovascular Disease Risk and Barriers to Heart Health: Lori Mosca MD, MPH, PhD, Heidi Mochari-Greenberger, MPH, RD, Rowena J. Dolor, MD, MHS, L. Kristin Newby, MD, MHS and Karen J. Robb, MBA. Circulation: Cardiovascular Quality and Outcomes Vol. 3 P-120-127. Published online before print February 10, 2010.
**National Study of Physician Awareness and Adherence to Cardiovascular Disease Prevention Guidelines: Lori Mosca, MD, MPH, PhD; Allison H. Linfante, EdD; Emelia J. Benjamin, MD, ScM; Kathy Berra, MSN, ANP; Sharonne N. Hayes, MD; Brian W. Walsh, MD; Rosalind P. Fabunmi, PhD; Johnny Kwan, MS; Thomas Mills, MA; Susan Lee Simpson, PhD. Circulation. Vol.111 P499-510 Published 2005.