Title : Gender disparities in heart disease, diagnosis and management
Abstract:
Heart disease is the leading cause of death worldwide effecting both men and women, however gender disparities are present in the diagnosis, treatment and even clinical outcomes. Clinical trials in cardiovascular disease have predominantly focused on male patients. Women with heart disease tend to present with atypical symptoms including nausea, epigastric discomfort, fatigue etc. instead of the heavy chest pain described by men. These symptoms are underplayed by family, friends and patients themselves. Women have socioeconomic barriers and caregiver burdens which also leads to delays in presentation. These factors lead to a delay in seeking medical attention and a delay in diagnosing. Studies have demonstrated that women are also less likely to get timely interventions.
Hormonal influences also play a role in disease progression. Women have a sharp increase in heart disease after menopause. The caregiving responsibilities, depression and level of stress is also higher in women with heart disease demonstrating a psychosocial relationship. Within the healthcare system, gender biases also exist which may minimize women’s atypical symptoms and lead to lack of interventions offered.
These disparities are due to a combination of biological, social and systemic factors. A multifaceted approach is needed to address these differences. Some changes needed are increasing female representation in clinical trials, development of sex specific diagnostic criteria & treatments along with educating clinicians on gender differences. Public health campaigns to provide education for women to recognize and seek treatment in a timely fashion is imperative along with raising awareness for the risk of heart disease especially after menopause. Recognition and addressing these differences are needed to provide effective cardiovascular outcomes for all patients irrespective of gender.
