December 5, 2024: Females continue to be underdiagnosed, undertreated, and underrepresented in clinical trials across all areas of cardiovascular disease, according to a consensus statement published online in the journal Heart.

Newcastle University’s Professor Vijay Kunadian, the lead author, and representatives from various UK cardiovascular, nursing, and patient organizations linked to the British Cardiovascular Society gave this statement.

Addressing Unmet Needs

The purpose of the consensus statement is to tackle unmet needs, ensure equitable care, and enhance health outcomes for women with cardiovascular disease in the UK and globally.

Professor Kunadian said, “Heart disease, in particular coronary artery disease, is the number one killer for women in the UK and worldwide. And yet, even to this day, we see that their symptoms are being ignored or women are told there is nothing wrong with them, or treated for something else, when all along they might be suffering from a heart problem."

Standard cardiovascular disease risk factors like high blood pressure and high cholesterol are frequently not addressed as effectively in women as they are in men, even though these factors account for about half of all preventable cardiovascular disease-related deaths.

Professor Kunadian added, “National databases indicate that year after year, women are undertreated, which unfortunately contributes to higher mortality rates after heart attacks," he remarked. "This issue cannot be overlooked any longer; it's time for action. Correct treatment could save women's lives. There is a common misconception that heart disease primarily affects men—when a man expresses discomfort, he is more likely to receive immediate attention from emergency services and healthcare professionals. We must shift this mindset and recognize that heart disease is also a women's issue."

Women encounter specific cultural, societal, and financial challenges that heighten their risk of heart disease, as well as hormonal influences related to pregnancy and menopause throughout their lives. Additionally, their biology and physiology can affect both their susceptibility to cardiovascular disease and the efficacy of diagnostic and treatment procedures.

Experts have concluded that both healthcare providers and the public often underestimate women's risk of cardiovascular disease compared to men.

Actions Required

The statement outlines several recommended actions for clinicians and their professional organizations across major cardiovascular disease areas, including coronary artery disease, valvular disease, heart failure, inherited heart disease, congenital heart defects, and heart rhythm disorders. Key actions include:

• Raising awareness of both traditional and women-specific risk factors for all types of cardiovascular disease.
• Ensuring women's inclusion in cardiovascular disease research.
• Informing the public and healthcare professionals that coronary artery disease is the leading cause of death for women.
• Guaranteeing equal access to specialized cardiac care, genetic testing, and family screening for women with inherited heart disease.
• Addressing the under-representation of women in clinical trials for new cancer immunotherapy treatments.
• Establishing registries to track cardiac toxicity from cancer chemotherapy for everyone, with a specific focus on women.
• Increasing participation of women in cardiac rehabilitation programs by providing hybrid or virtual options.
• Enhancing clinician awareness of the strengths and limitations of diagnostic methods for women with suspected or confirmed cardiovascular disease.
• Making women’s cardiovascular health a collective responsibility by incorporating it into primary care clinicians’ contractual obligations.
• Using influence to address sex biases in healthcare.

Patients and advocates can also contribute to the advancement of care for women's cardiovascular health by:

• Advocating for a holistic, woman-centered approach to heart care that considers women's experiences and perspectives.
• Engaging the media to promote awareness of the significance of cardiovascular health for women.
• Customizing information to meet women's unique needs.
• Highlighting heart conditions that primarily or exclusively affect women.
• Co-designing training for healthcare professionals to better address women's specific needs.

The statement additionally proposes the creation of women’s heart champions for peer support, dedicated women’s heart hubs to monitor conventional risk factors like blood pressure, cholesterol, and weight, and to provide lifestyle advice on diet and exercise. It also calls for the development of a women's health strategy.

Reference

Consensus statement: Advancing the access to cardiovascular diagnosis and treatment among women with cardiovascular disease: a joint British Cardiovascular Societies’ consensus document. Heart. Vijay Kunadian et al. Doi 10.1136/heartjnl-2024-324625.

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