Study finds gap between heart disease outcomes in men and women has narrowed over past 20 years

(Press-News.org) While the typical image of someone suffering a heart attack might be a man clutching his chest, heart disease is a major problem for women, too. In fact, it’s the leading cause of death among women in the United States, with nearly 45% of the nation’s women over age 20 living with some form of cardiovascular disease.

A new study from heart researchers at Intermountain Health in Salt Lake City shows that while rates of death and other cardiac-related events – like heart attack ­– are still high for women, the gap is narrowing when it comes to the rates of similar events in men.

“The reality is that women are different from men and need to be evaluated, diagnosed, and treated differently for heart disease,” said Kismet Rasmusson, NP, principal investigator of the study and a cardiovascular nurse practitioner in Intermountain Health's Advanced Heart Failure Program. “While these findings show that we’ve made progress with the care of women in our local area, we still have a long way to go. At Intermountain, we are answering a call to action put forth by national leaders in women’s cardiovascular health to pursue more research to understand the differences in cardiac disease between women and men.”

For the retrospective study, Intermountain researchers examined the electronic health records of 14,248 women and 26,524 men who underwent coronary angiography at Intermountain facilities between 2000 and 2019.

A coronary angiography is a medical imaging procedure that uses X-rays and contrast dye to visualize the coronary arteries, which supply blood to the heart. If the arteries become blocked, there is the risk of having a heart attack.

In reviewing health records of both men and women treated for heart disease, researchers found that men were more likely to be smokers with previous heart attack, left ventricular dysfunction, and hyperlipidemia, a condition characterized by high levels of fats (lipids) in the blood, such as cholesterol and triglycerides. 

Women studied tended to be older with more comorbidities (like high blood pressure, diabetes, and history of stroke and heart failure), have more stable chest pain, and experience less severe chest pain or heart attack when they came into the catheterization laboratory.

Through the review, Intermountain researchers also found that women had less severe blockage in the arteries in the heart and less revascularization by 60 days, and men received more coronary artery bypass graft. 

They also found that women with significant blockages received fewer prescriptions of cardiac medications, proven to impact outcomes. 

Over the 19-year study period, the rates of patient who experienced a major cardiac event within one year and three years – like heart attack or death – were higher in women, driven largely by more women dying.

However, when broken down into five-year periods, researchers found that the differences between men and women for major cardiac events narrowed over time, with no significant differences by sex from 2015-2019.

“Our findings mirror what others have published, that women have unique risk factors, and their extent and location of heart disease differs compared to men,” added Rasmusson.

While this research was done on a large study group, it still only includes patients from one health system, which may not be reflective of national trends.

In 2009, 65% of women were aware of their risk for developing heart disease. This trend has worsened over time. By 2019, 44% of women were aware of their risk for heart disease.

This was confirmed in a 2021 study published in the journal, Circulation, which found that less than half of women were aware of their heart disease risk. During this same time frame, there was a significant increase in awareness of the risk of breast cancer. 

“We know that locally and nationally there is a problem of lack of awareness and under treatment of heart disease in women,” Rasmusson said, in part because the field of cardiovascular medicine and research has predominantly focused on men.  

“Women need to know their risk of heart disease is equal to that of men, and is the leading cause of death, more so than all cancers combined. Women need help to manage their risk factors, recognize cardiac symptoms and seek prompt care – this will make a difference,” she said.

Findings from the study were presented at the American College of Cardiology’s annual scientific sessions conference in Chicago on Monday, March 31.

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