Tragically, women may still come up short when it comes to the diagnosis and treatment of heart disease. Mayo Clinic’s Dr. Sharonne Hayes, cardiologist and founder of the Mayo Women’s Heart Clinic in Rochester, Minnesota spoke recently to staff from WomenHeart: The National Coalition for Women With Heart Disease .
Learn more here about why the inequities of this cardiology gender gap continue, and how women can empower themselves and others to achieve equal and quality care for their hearts:
WH: “Recent studies show that compared with men, women have a 50% greater chance of being delayed in the hospital Emergency Room setting, and that women are less likely to receive the same care as men in the hospital setting generally. Do these studies suggest doctors and emergency first responders are really having trouble spotting heart attack symptoms in women?”
Dr. Hayes: “Yes. While on one hand, these findings are discouraging and reflect true disparities in care, on the other, we have to acknowledge that health care providers’ best efforts are hindered by the lack of good science about women and heart disease.
“There is no good study out there that tells us how similar or different women are from men when it comes to heart attacks. Sometimes, the symptoms are not clear, clustered differently, and can be attributed to something like indigestion or anxiety.
“If you find yourself in an ambulance or Emergency Room, don’t be afraid to say to the paramedic or triage nurse, “I think I’m having a heart attack!” You want a proper diagnosis, and a straightforward blood test and EKG are the starting points. If the thought crossed your mind that you might be having a heart attack, you need to speak up.”
WH: “Why do these differences exist in the care being given to men and women?”
Dr. Hayes: “There are multiple reasons. Misconceptions about women’s heart disease grew roots decades ago. In the 1960s, erroneous assertions that heart disease was a man’s disease were widely spread to the medical community and to the public. This led to research almost exclusively focused on cardiovascular disease in men. Many clinical trials in the 70s and 80s excluded women or simply didn’t make an effort to enroll women in sufficient numbers to draw sex-based conclusions.
“Things are improving, because doctors are now talking more about gender and examining the process of heart disease in women. They want to provide the best care and they think that they are.
“And health care consumers are doing more too. As a patient, you can ask your doctor “What are you doing to improve the care of women with heart disease?” It’s a question worth asking. And we can’t underestimate the efforts of WomenHeart and other organizations that are doing a great job of educating and empowering women to be more knowledgeable and proactive about their heart health.
“Right now, treatment guidelines help women get the care that has been shown to improve survival and long term outcomes in large groups of patients. Part of the problem now is that the guidelines are less likely to be applied to women compared to men. We know that when hospitals have systems in place to ensure they provide care according to the guidelines, women’s outcomes improve, even more than men’s.”
WH: “As researchers learn more about the physiological differences between male and female heart disease, do you anticipate doctors will begin to make better and faster diagnoses?”
Dr. Hayes: “Yes, with the caveat that research takes time to trickle down to the bedside or patient care. The research community is good at discovering new things, but slow in putting them into practice. For example, studies in the 1990s that showed that ACE inhibitors should be used in heart failure patients took seven years to trickle down to actual patient care. Much more data is needed, and again one important way women help move the needle is by participating in clinical trials.”
Visit WomenHeart for many other helpful resources on the subject of women and heart disease.
NOTE FROM CAROLYN: I wrote more about the cardiology gender gap (including several quotable quotes from Dr. Sharonne Hayes!) in my book A Woman’s Guide to Living With Heart Disease (Johns Hopkins University Press, 2017).
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- Heart Disease: Not Just A Man’s Disease Anymore
- How Doctors Discovered That Women Have Heart Disease, Too
- Gender Differences in Heart Attack Treatment Contribute To Women’s Higher Death Rates
- How a Woman’s Heart Attack is Different From A Man’s
- Women Heart Attack Survivors Know Their Place