Women are underrepresented in heart-disease research, warns American Heart Association

11 May 2022 --- While there is a gamut of heart-health risks specific to women, they remain underrepresented in heart disease research, according to a new report by American Heart Association.

The report stresses that sweeping changes are needed in how women’s heart health is examined, taught and treated. 

"We are losing ground on key indicators of cardiovascular health among women, including blood pressure control, weight management and diabetes,” asserts advisory co-author and a senior investigator at the National Heart, Lung, and Blood Institute of the National Institutes of Health, Dr. Véronique L. Roger.

According to the American Heart Association (AHA), heart disease is the leading cause of death in the US. Between 2015 and 2018, 44% of women aged 20 years and older were suffering from cardiovascular disease, including high blood pressure.

Gender-biased knowledge
Using data specific to women could improve diagnosis and treatment for heart disease.Roger explains that comparing data from women with data from men positions data from men as the “gold standard.” 

“The belief that women having a heart attack will present more often with atypical symptoms carries an undertone that women present in the ‘wrong way’,” he warns.

Using data specific to women could improve diagnosis and treatment for heart disease. 

“We must urgently address the pervasive gaps in knowledge and health care delivery to reduce gender-based disparities and achieve equity,” stresses the report’s co-author and emeritus professor of medicine in the division of cardiology at Emory University School of Medicine in Atlanta, Dr. Nanette K. Wenger.

However, the report flags that 70% of post-graduate medical trainees reported little to no training regarding gender-based medical concepts. Only 22% of physicians and 42% of cardiologists felt prepared to assess heart disease specific to women adequately.

The awareness of heart health is also declining among women. In 2019, only 44% of women were able to accurately name heart disease as women’s leading cause of death. 

Next to that, the nutrition industry also tends to overlook the demands of women in different life stages.

Higher risk for women
Some heart disease risk factors are specific to women. Specifically, women who start their menstrual cycle younger than 11 or enter menopause younger than age 40 are at a higher risk of developing a cardiovascular illness.

Women are also more affected by inflammatory and autoimmune disorders such as lupus, rheumatoid arthritis and scleroderma, which are associated with an increased risk of heart inflammation, heart and valve disease and heart attacks.

The advisory highlights that declining heart health among US women considering pregnancy and less-than-optimal levels of heart health among pregnant women is particularly worrisome. 

Heart problems may cause pregnancy challenges and complications for the mother and her children.

Women also face risks related to high blood pressure or diabetes during pregnancy. 

Meanwhile, oral contraceptive use and hormone replacement therapy, as well as breast, uterine or ovarian cancer treatment, can also worsen heart conditions.

Notably, depression and anxiety are associated with heart disease more frequently and at younger ages in women than in men.

Only 22% of physicians and 42% of cardiologists felt prepared to assess heart disease specific to women adequately.More research needed
Wenger adds that solving this problem requires cooperation between experts from different fields. “We recommend cardiologists, primary care physicians and obstetricians and gynecologists work together to quantify and reduce the risks of cardiovascular disease throughout a woman’s life.”

The advisory recommended developing educational, culturally sensitive heart health awareness campaigns that focus on the benefits of prevention. 

Additionally, more research on women, particularly younger with diverse racial and ethnic backgrounds, is needed to help deliver more effective health care.

The advisory also underlined the crucial role of affordable health insurance coverage. According to AHA, under the Patient Protection and Affordable Care Act signed in 2010, women between the age of 19 and 64 saw the largest coverage gain of any demographic group.

“We need to help women develop a ‘lifetime approach’ to their health, where they are empowered to manage their heart disease risk in every life stage proactively,” said Wenger. 

Meanwhile, there is a growing awareness of nutrition playing a role in combating health problems. Earlier this year, a study by Columbia University discovered that cereal fiber consumption could reduce inflammation in elderly adults. 

Previously, NutritionInsight reported rising demand for natural and sustainable options in the heart health space.

Edited by Ilze Vitola