More Women than Men Die of Heart Disease: Are Male-Oriented Diagnostics Part of the Problem?

A leading women’s heart expert says flat-out yes and calls for a diagnostic overhaul that hopefully will lead to improved screening and timely, more effective treatment of the No. 1 cause of women’s deaths. In a 2014 article in the cardiovascular journal Circulation, C. Noel Bairey Merz, M.D., of the Barbara Streisand Women’s Heart Center in Los Angeles, spotlights major research that clearly demonstrates a “female-specific pattern of ischemic heart disease” characterized by dysfunction in smaller branches of the coronary arteries that feed the heart. The pattern is different from typical male-oriented obstructive coronary artery, as determined by angiography, clogging the larger arteries.

The dysfunction in the smaller coronary branches “is not routinely recognized” by current male-pattern diagnostic angiography that dominates the practice of cardiology, Dr. Bairey Merz points out. Current strategies, “developed in men, for men, and by men, fail to diagnose approximately 20 to 30 percent of women with ischemic heart disease.”

Prior research has demonstrated that women are less likely to receive appropriate therapy that can save lives, she argues. “Lack of recognition of biological sex-based differences in diagnosis…result in failure to treat,” a knowledge gap that must be closed as a high priority in order to appropriately address heart disease in women.

 My Viewpoint: This is a serious issue. Women constitute more than half of all ischemic heart disease deaths, representing the majority of cardiovascular deaths. Yet women represent only one-third of the diagnosed cases of coronary heart disease and heart attack; 70 percent are men. Something is wrong with this picture. Ischemic heart disease, also known as coronary heart disease, is the most common type of heart disease and cause of heart attacks. It occurs typically – but apparently more in men than women − when plaque narrows the larger coronary arteries, or bursts, resulting in blockage of the flow of oxygen and nutrients to the heart muscle.

 What this Means to You: Women have an anatomical disadvantage. They have smaller arteries than men to begin with. They are often misdiagnosed and get delayed treatment because doctors look for the standard male pattern disease and don’t find it, and also because women’s symptoms don’t always match that of men. Women need also to be more aware of the impact of emotional stress. Stress, of course, can lead to hypertension, a significant risk factor. Research by Dr. Bairey Merz has shown also that stress can cause chest pain and critical oxygen deficit in women as a result of dysfunction in the smaller arteries of the heart.

 Recommendation: Educate yourself. Talk to your doctor about gender-related differences in diagnostics and treatment. Get medical attention if you have any chest discomfort or shortness of breath. If tests show your main coronary arteries as normal, get your coronary microcirculation checked out as well. That’s where the blockage could be. Whether the arteries are large or very small, blockage can leave the heart starved for oxygen. Be proactive and get stress under control and boost your heart health with Earthing and targeted nutritional supplements that protect and relax blood vessels.

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© 2014 HeartMD Institute. All rights reserved.

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