Dr Clare Appleby
Thursday 14th March 2024
In the realm of healthcare, the perception of cardiovascular disease (CVD) often conjures images of middle-aged men clutching their chests. However, this image overlooks a critical reality: women are equally susceptible to cardiovascular disease, yet their symptoms are often under-investigated, under-diagnosed and under-treated in comparison. As a society, it is imperative to dispel the gendered myths shrouding CVD and recognise the profound impact they have on women's health outcomes.
In the United Kingdom, CVD remains the leading cause of mortality among women, claiming the lives of approximately 28,000 women annually. Statistics reveal that women are more likely to die within the first year following a heart attack compared to men. Studies suggest that women with aortic stenosis are less likely to be admitted to a cardiology bed, are less likely to see a cardiologist and will undergo fewer echos than their male counterparts. However, with timely treatment, outcomes for women are better.
Unravelling the complexities of the gender health gap requires recognition of multiple factors that might contribute to such disparities. Societal norms often perpetuate the misconception that CVD primarily afflicts men, leading to delayed recognition and treatment of symptoms in women. Additionally, diagnostic and treatment protocols historically derived from male-centric research may fail to adequately address differences in female cardiovascular physiology. Consequently, women may face delayed or misdiagnosed interventions, exacerbating the severity of their condition and compromising their overall health outcomes.
Beyond clinical biases, socio-cultural determinants further exacerbate this situation. Prevailing gender roles may discourage women from prioritising their cardiovascular health, prioritising instead those they care for. Furthermore, systemic barriers, such as disparities in access to healthcare and financial constraints, may disproportionately affect women, hindering their ability to seek timely medical intervention.
Addressing gender inequities in CVD necessitates a paradigm shift within both clinical practice and societal discourse. Healthcare professionals must adopt a gender-sensitive approach to CVD, recognising the manifestations and risk factors prevalent in women. By integrating sex-specific research and diagnostic tools into clinical practice, practitioners can enhance the accuracy of CVD detection and tailor their interventions.
Moreover, empowering women to prioritise their cardiovascular health is paramount. Education initiatives aimed at raising awareness of CVD risk factors and symptoms among women can foster proactive engagement with healthcare services, facilitating early detection and intervention. Equally important is the dismantling of societal stereotypes that undermine the seriousness of CVD in women.
In conclusion, attitudes towards cardiovascular disease perpetuate disparities in health outcomes for women. By challenging prevailing biases within clinical practice and fostering a culture of awareness and empowerment, we can start to mitigate the detrimental impact of gender disparities on women's cardiovascular health and pave the way towards equitable healthcare outcomes for all.
Dr Clare Appleby, Consultant Cardiologist at Liverpool Heart and Chest Hospital and Clinical Lead for Intervention and TAVI