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IWD 2024 – Heart Health Inequality: The Overlooked Gender Gap in Cardiovascular Disease

🌟 We are celebrating International Women’s Day (IWD) by taking a deeper dive in the specific health needs of women, focussing on preventative healthcare and health promotion 🌟

In general practice, we witness firsthand the profound impact of cardiovascular disease (CVD) on women’s lives. Despite being the leading cause of death for women globally1, heart disease often goes unrecognised, under-diagnosed and under-treated due to misconceptions that CVD primarily affects men. It’s imperative to recognise the subtler signs of CVD in women and take proactive steps towards prevention.

In women, symptoms of CVD can manifest differently than in men. While chest pain is a common symptom of a heart attack for both genders, women may experience atypical and more non-specific symptoms such as2:

  • Neck, upper back or abdominal pain
  • Nausea or vomiting
  • Shortness of breath
  • Fatigue
  • Dizziness or feeling lightheaded
  • Indigestion or reflux2

These symptoms are often overlooked or attributed to other conditions, leading to misdiagnosis or delayed treatment. Research also shows that women are much less likely to undergo treatment for heart attack or angina (chest pain) in hospital compared to men, exacerbating the disparity in care and outcomes3.

In addition, images and representations of cardiovascular disease in medical literature and public health campaigns traditionally have predominantly featured men, contributing to the misconception that CVD primarily affects males. Even medical textbooks commonly depict symptoms and cases of heart disease using images of men, leading to a lack of awareness about the unique presentation of CVD in women.

Certain risk factors like diabetes and stress can disproportionately adversely affect women’s heart health and pregnancy-related issues such as gestational diabetes or preeclampsia serve as warning signs for future cardiovascular risks. Additionally, the menopausal transition, characterised by decreased estrogen levels, is associated with an increased risk of developing CVD4.

Why does this matter?

Because understanding these gender-specific symptoms and risk factors is essential for tailored diagnosis and treatment in women. Awareness is the first line of defence: recognising the nuances in how CVD presents in women could potentially save lives.

Women must be supported to take an active role in their cardiovascular health by scheduling regular check-ups with healthcare professionals who are knowledgeable about these gender differences. Ensuring women undergo regular screenings for blood pressure, cholesterol, and blood sugar levels can provide an early detection advantage5.

Lifestyle modifications are integral to reducing risk. Adopting a heart-healthy diet, engaging in regular physical activity, maintaining a healthy weight, avoiding smoking, and managing stress are crucial steps5. Additionally, understanding one’s family history is essential, as genetic predisposition can significantly impact risk5.

In my practice, I encourage my patients to communicate openly about any new or unusual symptoms they may experience, and together, we develop personalised preventative strategies. Empowering women to speak up and question potential
heart-related symptoms is a cultural shift that can lead to improved outcomes.

In  conclusion, the urgency for heightened attention and awareness surrounding cardiovascular disease in women cannot be overstated. Through proactive education on their distinctive risks and symptoms, coupled with the promotion of heart-healthy lifestyles, we hold the power to steer the course of women’s cardiovascular health towards a brighter future. Let’s unite in spreading this crucial message and acknowledging that heart health isn’t exclusively a men’s issue—it’s everyone’s issue. Let’s address it with the urgency and commitment it deserves.

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1. WHO. Global Health Estimates: Life expectancy and leading causes of death and disability [Internet]. 2024. Accessed 2024 Feb.

2. Mayo Clinic. Heart disease in women: Understand symptoms and risk factors [Internet]. 2024. Accessed 2024 Feb.

        3. Australian Bureau of Statistics. Causes of Death, Australia 2019. Vol 3303.0. 

4. Desai S, Munshi A, Munshi D. Gender bias in Cardiovascular disease prevention, detection and management. J Midlife Healt[Internet] 2021 Jan-Mar [Accessed 2024 Feb]. 12(1): 8–15. doi: 10.4103/jmh.jmh_31_21

5. RACGP. Guidelines for preventative activities in general practice [Internet]. 2024 [accessed 2024 Feb].