Coronary heart disease is under-diagnosed and under-treated in women

September 01, 2005

Coronary heart disease is under-diagnosed, under-treated, and under-researched in women, says a senior doctor in this week's BMJ.

Cardiovascular disease remains the leading cause of death in men and women worldwide, exceeding the number of deaths from all cancers combined. In Europe, cardiovascular disease kills a higher percentage of women (55%) than men (43%). Yet it is still considered a disease of men.

Many women are unaware that coronary heart disease is their main killer; their biggest fear is breast cancer, writes cardiologist Ghada Mikhail. Even more worrying is the apparent lack of awareness of cardiovascular disease in women among healthcare professionals.

Women and men with heart disease tend to differ in their presenting symptoms, their access to investigations and treatment, and their overall prognosis. For example, women may have less common symptoms, are less likely to seek medical help, and tend to present late in the process of their disease.

They are also less likely to have appropriate investigations, which can delay the start of effective treatment.

Women also continue to be under-represented in research on heart disease, making it difficult to draw conclusive evidence on managing cardiovascular disease. To remedy this, the author suggests that participants' sex must be considered in the design and analysis of cardiology studies.

Better awareness and education, earlier and more aggressive control of risk factors, and appropriate access to diagnosis and treatment are desperately needed to tackle this potentially fatal disease, she concludes.
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BMJ

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