I just finished reading a truly weird rant on another website, written by a man decrying the “sexism” of society because all of our male doctors are now focused only on women’s heart disease – while apparently ignoring men completely. It turns out he’s not alone in his misinformation: see also Women’s Heart Health: Why it’s NOT a Zero Sum Game.
It would surely be the fantasy dream of every female heart attack survivor if this man were actually correct about all that attention women’s heart disease is allegedly attracting. The frightening reality instead is that since 1984, the differences between men and women’s cardiac diagnoses, treatments and outcomes has continued to grow.
In the interests of enlightening the unconscious among us about All Things Cardiac, I am happy to point out an assortment of gender differences if you find yourself having a heart attack:
- 1. For women under the age of 50, heart attacks are twice as likely to be fatal as men’s.
- 2. Women are twice as likely as men to die within the first month after suffering a heart attack.
- 3. Marital stressworsens the prognosis in women with heart disease – but not in men.
- 4. Men’s coronary artery plaque tends to distribute in clumps, whereas women’s tends to distribute more evenly throughout artery walls, thus lending credibility to cardiologists’ suspicion that “men explode, but women erode“. This tendency results in women’s diagnostic tests (designed to detect those large artery-blocking clumps in white, middle-aged men) frequently being misinterpreted as “normal”.
- 5. Women wait longer than men to go to a hospital Emergency Department when experiencing heart cardiac symptoms.
- 6. Average risk of being misdiagnosed in mid-heart attack for both men and women is about one in 50 – unless you’re a women under 55, in which case you are seven times more likely to be misdiagnosed compared to men.(1)
- 7. After a heart attack, women are less likely than men to receive standard treaments like beta blockers, ACE inhibitors and even aspirin – therapies known to improve survival. This contributes to a higher rate of complication after heart attacks in women, even after adjusting for age. See also: Fewer Lights/Sirens When a Woman Heart Patient is in the Ambulance.
- 8. Over 46% of women but only 22% of men heart attack survivors will be disabled with heart failure within six years.
- 9. Women are 2-3 times more likely to die following open heart bypass surgery. But younger women between the ages of 40-59 are four times more likely to die from bypass surgery than men of the same age.
- 10. Women with diabetes have more than double the risk of heart attack than women who are not diagnosed with diabetes. Diabetes doubles the risk of a second heart attack in women, but not in men. Diabetes affects many more women than men after the age of 45.
- 11. Women who are eligible candidates to receive life-saving clot-busting drugs in hospital are far less likely than our male counterparts to receive them.
- 12. The best course of treatment for a woman with heart disease has yet to be established, but women currently receive fewer cardiac procedures than men. Cardiologist Dr. Benjamin Lewis once told Healthline interviewers: “Women really have to almost earn their way into the healthcare system through an acute illness as opposed to men, who are more likely to be diagnosed before some catastrophe strikes.”
- 13. Women comprise less than 24% of participants in all heart-related research studies even though we make up 53% of heart patients. In fact, for generations, even the lab animals used in medical research have been male animals.
- 14. In 2016, the American Heart Association released its first ever scientific statement on women’s heart attacks, confirming that “compared to men, women tend to be undertreated.” I can’t decide, by the way, what part of that announcement upset me more at the time: its conclusion, or the fact that this was the first time ever in the 92-year history of the AHA that a statement on women and heart attacks had been released!
(1) Pope JH, Aufderheide TP, Ruthazer R, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 2000;342:1163-1170.
NOTE FROM CAROLYN: I wrote much more about the cardiology gender gap in Chapter 3 of my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).