BOSTON - Research shows that the differences between heart health in women and men are often under-recognized, placing women at increased risk. Beth Israel Deaconess Medical Center (BIDMC) has responded by launching the Women's Cardiovascular Health Program.
"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."
In fact, 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, Feinberg says. The latest research shows that a woman dies of heart disease almost every minute in the United States.
American Heart Association 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. "Many women are not being properly diagnosed and treated," says Mark Josephson, MD, chief of the Division of Cardiovascular Medicine. "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."
Josephson 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.
"Our cardiovascular specialists have addressed women's heart needs for some time," says Josephson. "But it has become clear that women should have more comprehensive, specialized care, which is now offered through our new program."
The program, part of the CardioVascular Institute (CVI) at BIDMC provides specialized care to evaluate and manage cardiovascular risk factors in women, treat heart disease in women, establish pre-pregnancy risk and care for pregnant women with cardiac disease and treat cardiovascular disease resulting from cancer treatment.
The program also hopes to bring attention to physician perceptions of women's heart health.
"Unfortunately, gender bias may still play an insidious role in influencing physicians' decisions," says 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.
According to 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, advises Feinberg. "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 at Beth Israel Deaconess Medical Center combines cardiology, cardiac surgery and vascular surgery in a single structure. It delivers outstanding outcomes, easy access and better service, earning BIDMC recognition from
U.S. News & World Report as one of the best 100 hospitals for heart care and surgery. Community-based cardiologists and vascular surgeons in Massachusetts and New Hampshire provide a wide range of services and, when advanced care is needed, refer patients to the CVI in Boston. For more information, including outcomes data, visit bidmc.harvard.edu/cvi.
Beth Israel Deaconess Medical Center is a patient care, teaching, and research affiliate of Harvard Medical School, and currently ranks third in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit