Red alert for women’s hearts
On the recent International Women’s Day the European Society of Cardiology (ESC) launched an appeal for the reduction in the disparities of the treatment of cardiovascular disease. A number of studies published in the European Heart Journal draw attention to shortfalls in applying best practice recommendations in the case of women’s heart disease.
"The ESC wants to raise awareness, among both cardiologists and the public, that women still are not receiving equal access to medical treatments and also are not being represented sufficiently in clinical trials, " said Marco Stramba-Badiale, an ESC spokesman on women’s issues.
Even though the consequences of cardiovascular disease in women are worse, there false ideas are still prevalent with health professionals and the public in general, both thinking that heart disease is less serious for women.
A woman’s delicate heart
Numbers from the World Health Organisation (WHO) indicate that a whopping 55% of women’s deaths are caused by cardiovascular disease, compared to only 43% of men’s deaths. To better understand the numbers, only 3% of women’s deaths are caused by breast cancer. In addition, recent figures from the National Health and Nutrition Examination Surveys (NHANES) of America show that over the last 20 years, the numbers of myocardial infarction (heart attack) in women aged from 35-54 have increased, while declining for men of the same age group.
Women are systematically receiving reduced levels of care and diagnosis
Studies published in the special edition of the European Heart Journal report that women find themselves prescribed a lot less medication than men. " We were shocked to find that even after infarction - the most dramatic cardiac situation we envisage - there’s still a dramatic under-utilisation of drugs in women, ", explained Professor Thomas F. Lüscher from University Hospital Zurich (Switzerland). “These issues need to be urgently corrected to ensure that women get equal access to state of the art treatments as men.”
In the EHJ print version, Noel Bairey Merz of Cedar-Sinai Heart Institute (California) underlines the fact that coronary microvascular dysfunction affects women more frequently than men. This is a condition where the artery’s is unable to dilate causing narrowing of the artery and reduced oxygen flow.
The condition, Merz believes, affects women far more frequently than men and may explain why it is more difficult to make a diagnosis in women. “We estimate that microvascular coronary dysfunction accounts for a third to one half of heart disease in mid-life women, but unlike obstructive CAD, it doesn’t show up on an angiogram making it more difficult to diagnose,” explains Merz.
Including women in clinical studies
The European Society of Cardiology is also calling for the inclusion of a larger number of women in clinical studies concerning cardiovascular disease. It has asked the European Medicines Agency (EMA) to consider making equal representation of women in clinical trials a requirement for the licensing of all cardiovascular medication being brought to market.
"It’s very important that data concerning women is analysed separately because there are often differences in the pharmacodynamics, pharmacokinetics and physiology in comparison to men, making it possible that the efficacy of drugs might be completely different in women," said Stramba-Badiale.
Source: ESC press release – March 2011
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