Gaps in understanding how women are affected by cardiovascular disease put their lives at risk, experts say, calling for greater action and investment to improve access, quality and equity in women’s heart health.
In a presidential council issued by the American Heart Association, leading heart doctors say women remain underrepresented in cardiovascular research – the number one killer of women in the United States and the United Kingdom – and that more needs to be done. emphasis on prevention and education. They suggested starting heart health programs in primary school to engage girls and enable families to take greater control of their health.
“We are losing ground on key indicators of women’s cardiovascular health, including blood pressure control, weight management and diabetes,” said Dr. Veronica Roger, author of the advisory committee and senior researcher at the National Heart, Lung and Heart Institute. blood in Bethesda, Maryland.
According to a study funded by the British Heart Foundation, more than 8,000 women died between 2002 and 2013 in England and Wales because they did not receive the same standard of care as men. Inequalities at every stage lead to late diagnosis of women and the lack of immediate treatment and follow-up care they need to survive a heart attack.
Roger added that there must be a cultural change in the way cardiovascular data is presented in research studies if health justice is to be achieved for women.
“Comparing women’s data with men’s data is essentially positioning men’s data as the gold standard,” Roger said. “For example, the belief that women with heart attacks are more likely to have atypical symptoms has a tinge that women present in the ‘wrong way.’
Instead, researchers need to focus on recruiting more women for clinical trials and analyzing their data more objectively, she said.
The council, published in the journal Circulation, outlines a roadmap divided into four key areas for attention and investment: epidemiology and prevention; awareness; access to and provision of fair health care; and the participation of health professionals, researchers and communities.
In particular, women and their doctors need to be trained in some women-specific factors that increase the risk of heart disease, such as the onset of menstruation before the age of 11; early menopause (before the age of 40); hormonal imbalances that lead to irregular ovulation, e.g. polycystic ovary syndrome (PCOS) or have unpredictable cycles.
Other risk factors include suffering from inflammatory and autoimmune diseases such as lupus, rheumatoid arthritis and scleroderma, or depression and anxiety – all of which disproportionately affect women – and risks associated with the use of oral contraceptives and hormone replacement therapy, or the treatment of various cancers. diseases that are more common in women, such as breast, uterine or ovarian cancer, some of which can damage the heart.
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Of particular concern is heart health among women considering pregnancy, where high blood pressure or diabetes may increase the risk of premature birth or the birth of a baby that is significantly above or below average birth weight, with potential long-term consequences for this child. . health.
“We recommend that cardiologists, primary care physicians and obstetricians work together to quantify and reduce the risk of cardiovascular disease throughout a woman’s life. These interdisciplinary partnerships are crucial to developing and implementing the best approaches that will lead to improvements in women’s overall health, “said Nanette Wenger, Honorary Professor of Medicine at Emory University School of Medicine, who chairs the advisory group.
“We need to help women develop a ‘lifelong approach’ to their health, in which they are empowered to proactively manage the risk of heart disease at every stage of their lives.”
Helen Wilson, head of research at Heart Research UK, said: “We fully agree with the American Heart Association that research on women’s heart health needs more investment to reduce the number of women living and dying from heart disease. vascular disease, and to improve their chances of surviving a heart attack. ”
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