While heart disease has long been recognized as the leading cause of death for both men and women in the United States, misconceptions about its impact on women persist. Despite decades of research, many still underestimate the risk women face in developing cardiovascular disease.
Heart disease claims the lives of one in five women in the U.S., with over 60 million women currently living with some form of the disease. Yet, for much of medical history, heart disease was seen predominantly as a male issue. Dr. Aga Silbert, a clinical cardiologist at UW Health and a clinical assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health, notes this historical misconception.
“For years, doctors believed that women weren’t suffering from heart disease in the same way men were,” said Dr. Silbert, emphasizing how the prevailing myth hindered accurate diagnosis and treatment.
Despite the fact that women tend to develop symptoms of heart disease about a decade later than men, they are not immune. Though less common, women can experience heart disease as early as their 20s. Additionally, a new misconception has emerged suggesting that women experience different heart disease symptoms than men. According to Dr. Silbert, this is inaccurate—women simply report their symptoms differently. Chest pain, the most common symptom of a heart attack, may be accompanied by symptoms such as nausea, back pain, or neck discomfort, which women are more likely to attribute to less serious conditions like acid reflux or the flu.
Such misinterpretations often lead women to delay seeking treatment. Dr. Silbert explains that while chest pain is still the hallmark symptom, women might describe it as pressure or tightness, or even experience no chest pain at all. For many, the first sign of a heart attack may be the attack itself.
Furthermore, despite having similar heart disease treatments available—such as medications, angioplasty, and coronary bypass surgery—women are less likely to receive these interventions. According to Dr. Silbert, physicians may hesitate to prescribe certain medications to women due to concerns over side effects. Additionally, women tend to have smaller arteries and more small vessel disease, which can complicate procedures like coronary artery bypass surgery.
Recovery is just as critical as treatment. Cardiac rehabilitation has proven to significantly improve survival rates, yet many women fail to utilize these services. “Only about 50% of women who should be receiving cardiac rehabilitation are doing so, and just one in three completes the program,” said Dr. Silbert, highlighting a gap in post-treatment care.
Preventative measures are essential. Dr. Silbert urges women to establish healthy lifestyle habits early, incorporating exercise, balanced nutrition, and stress management techniques. These steps, she believes, play a crucial role in reducing the risk of heart disease later in life.
Pregnancy adds another layer of risk for women. Conditions like preeclampsia, gestational diabetes, and hypertension can all increase the likelihood of developing cardiovascular issues in the future. Dr. Silbert notes that many women are not in optimal health before pregnancy, increasing their risk even at a young age. In Wisconsin, at least 20% of new mothers have high blood pressure, which, if uncontrolled, can lead to severe complications such as stroke, organ damage, or even death.
Recognizing and addressing risk factors like high blood pressure, high cholesterol, and diabetes are key to preventing heart disease. Dr. Silbert stresses the importance of early detection and prompt treatment to mitigate long-term risks.
Historically, women were underrepresented in heart disease research due to concerns about pregnancy’s impact on study results. As a result, treatment guidelines were largely based on male data, leaving a significant gap in our understanding of how heart disease affects women. Dr. Silbert calls for continued research to better understand the causes, symptoms, and treatments specific to women.
Advocacy efforts have helped raise awareness about the issue, but Dr. Silbert acknowledges that much work remains. “The discrepancy in cardiovascular health care between men and women is not new, but it has been gradually improving,” she said.
February is American Heart Month, an annual campaign to raise awareness about heart disease and promote cardiovascular health. “While it would be ideal for this conversation to be ongoing year-round, dedicating a month to heart health is a step in the right direction,” Dr. Silbert added.
Raising awareness and encouraging proactive health measures can help close the gender gap in heart disease prevention and treatment.
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