We Need All Hands on Deck for Women's Heart Health

By Dr. Janine A. Clayton

dr claytonHeart disease affects men and women nearly equally, but for decades it was considered a “man’s disease.” There is no way to know how women would have fared if their heart health had received appropriate attention over that same period, but it is now time to finally right the ship of women's heart health. And for this, we need all hands on deck.

The recognition of heart disease as also a “woman’s disease” and even a “young woman’s disease” is slowly improving, but awareness of the risk of the disease is still very low among women. Particularly at risk are young, working-age women, who may have increased demands on their time and largely push their own health to the side.

Also, because women can have different symptoms and signs of heart disease than men, there is a possibility that their disease risk is being underestimated. Additionally, sex-specific results are often not reported in published scientific papers, even when women were included in the research studies. These results therefore are not available to doctors when they are taking care of women. Consequently, women today may be receiving suboptimal care compared to men for an illness that can have deadly consequences.

The National Institutes of Health (NIH) has endeavored to recruit more women for clinical trials, and today, more than half of the participants in NIH-funded clinical research are women. NIH is also working to ensure women are appropriately represented, not just in aggregate, but also on a more disease-specific basis — particularly regarding heart disease. Important differences exist between men and women’s hearts that play key roles in health and disease. Therefore, the continued engagement of women as partners in clinical research is vital. 

But for all the work that NIH and its phenomenal research participants are doing, we alone cannot undo the deep effects of the decades-long misconception of heart disease as just something older men get.

We encourage all health scientists - whether funded by NIH or not - to study both men and women in clinical research and consider the possible influences of sex at every stage of the research process (from animal models to humans). This includes scientists at pharmaceutical companies.

We encourage individuals, women's groups, colleges and universities, tribal organizations, the media, and others to help spread the word about heart disease among women. This would be particularly beneficial at historically African American colleges and universities, considering that there is a higher prevalence of heart disease among African American women than women of other race/ethnicities.

Moreover, we encourage physicians to increase their index of suspicion for heart disease when they encounter women with vague symptoms (for example, pain, indigestion, fatigue). Women's heart health can be improved by physicians actively implementing available evidence in their practices, along with quality improvement activities targeted to women and heart disease. When examining how people are responding to a treatment or intervention, it is important for medical providers to look separately at how women and men are doing.

Prevention is critical and there are definite steps women can take to reduce their risk (see list below). However, I have had girlfriends who did everything right: They had good dietary habits, were not overweight, were not diabetic, and didn't smoke. Yet, despite this, some lost their lives due to a heart attack, and at a very young age. One friend lost her life following a heart attack not long after giving birth. These are cases where perhaps genetics played a role and highlight the importance of every patient knowing her or his family health history when possible and remembering that "You are your best health advocate."

However, it will only be through a heightened sense of urgency and strong partnerships among various individuals and organizations that we will be able to chart a new course for optimizing women's heart health.

With love in their hearts, women spend much of their time taking care of everyone else. It is now time that everyone come together to protect those hearts that love so many.

More information on heart disease is available on the National Heart, Lung, and Blood Institute’s Website: www.nhlbi.nih.gov/health/health-topics/topics/cad.

To interview a health expert, contact the NIH Office of Research on Women’s Health at ORWHinfo@mail.nih.gov or 301-402-1770.

To join a clinical trial, visit: clinicaltrials.gov

Some steps you can take to reduce your risk of heart disease:

Source: National Heart, Lung, and Blood Institute, www.nhlbi.nih.gov.