Fact checked by Nick Blackmer
Women are more likely to die after a heart attack than men, new research shows.
The findings suggest that women may need additional monitoring and check-ins after a heart event to stay healthy.
Heart disease is the leading cause of death among women in the United States.
Women may be more than twice as likely to die after a heart attack, compared to men, according to new research – important findings as heart disease is the leading cause of death among women in the United States.
The new study, presented at Heart Failure 2023, a scientific conference of the European Society of Cardiology, found that women hospitalized for a heart attack were more likely than men to experience adverse outcomes, including death and future cardiovascular events. of similar age.
“In general, women have a lower risk of cardiovascular events than men,” said study author Mariana Martinho, MD, a cardiologist at Hospital Garcia de Orta in Portugal. Health. “But if they have a myocardial infarction, which is commonly known as a heart attack, they are at a higher risk of developing future events and dying from the disease.”
The findings suggest that women may need additional monitoring and medical check-ins after a heart event to stay healthy.
“These women need regular monitoring after their heart disease, with strict monitoring of blood pressure, cholesterol levels and diabetes, and referral to cardiac rehabilitation,” said Dr. Martinho in a press release. “Smoking rates are rising in young women and this needs to be addressed, along with promoting physical activity and healthy living.”
Women more likely to die after a heart attack
For the study, researchers compared short- and long-term outcomes after ST-elevation myocardial infarction (STEMI) — a type of heart attack in which a coronary artery is completely blocked — in both men and women to determine sex differences.
The retrospective observational study included 884 patients hospitalized with STEMI and treated with percutaneous coronary intervention (PCI) between 2010 and 2015. , and 5-year serious adverse cardiovascular events.
Percutaneous coronary intervention (PCI) is a nonsurgical procedure in which a stent is placed in a blocked artery to improve blood flow.
Of all 884 patients, the mean age was 62 and 27% of patients were female. Women were also older than men and had more hypertension, diabetes and previous strokes – men, however, were more likely to smoke and have coronary artery disease.
After adjusting for those risk factors and health problems, researchers found that women had worse short-term and long-term outcomes, as well as additional cardiovascular events after a heart attack.
At the 30-day follow-up, 11.8% of women had died of a heart attack, compared to 4.6% of men. After five years, 32.1% of women had died compared to 16.9% of men; and 34.2% of women had an additional cardiovascular event compared to 19.8% of men.
“Women were two to three times more likely than men to have short- and long-term adverse outcomes, even after adjusting for other conditions and despite receiving PCI within the same time frame as men,” said Dr. Martinho in a press release.
For the same study, researchers performed an additional analysis by matching men and women based on cardiovascular disease risk factors, then comparing the adverse outcomes for men and women 55 and older and 55 and younger.
In that analysis, women were still more likely to die after a heart attack or have an additional adverse cardiovascular event.
Postmenopausal women (55 years and older) had higher rates of 30-day mortality, five-year mortality, and five-year major cardiovascular events. Among premenopausal women (55 years and younger), women were almost four times more likely than men to have an additional major cardiovascular event, although no differences were found in all-cause mortality after 30 days or five years.
“Postmenopausal women had worse short-term and long-term outcomes after a heart attack than men of the same age. Premenopausal women had similar short-term mortality but worse long-term prognosis compared to their male counterparts,” said Dr. Martinho in the press release. “Although our study did not examine the reasons for these differences, atypical symptoms of myocardial infarction in women and genetic predisposition may play a role.”
Related: Heart Attack Symptoms Women Shouldn’t Ignore
More awareness needed for heart disease in women
The new study is far from the first to highlight gender differences in cardiovascular disease outcomes.
“I’m disappointed that this most recent study continues to show what we’ve seen time and time again,” Holly S. Andersen, MD, a cardiologist and associate professor of clinical medicine at New York-Presbyterian Hospital, Weill Cornell Medical Center, told WebMD. Health. “Once a woman is diagnosed with heart disease, she will fare worse and be more likely to die from it than a man.”
For example, a 2020 study published in the journal Circulation, examined data from more than 45,000 first-time heart attack patients to determine any gender differences, and found that women had a higher risk than men of dying or developing heart failure in the five years following a heart attack. In addition, a 2017 study found that women had a significantly higher risk of dying in the first year after a heart attack, compared to men.
“The increased mortality in women after heart attack has been shown in other previous studies and it is concerning that it continues to be shown in studies like this one,” Laxmi Mehta, MD, a cardiologist at The Ohio State University Wexner Medical Center, told me. Health.
“In the past, women have been shown to have worse outcomes because of their older age and other risk factors compared to men,” Dr. Mehta. “Interesting in [the new study]even after adjusting for risk factors such as diabetes, hypertension, high cholesterol, previous stroke – women still fared worse than men.”
While more research is needed to understand why there is a gender disparity in cardiovascular outcomes, experts say a lack of awareness of heart disease symptoms and risk factors in women may be at least partly to blame.
“The perception of heart disease is that it’s a man’s disease,” Nicole Weinberg, MD, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California, told me. Health.
“The more I talk to women, they say they go to doctors, but they look for the big, bad things and not the little, insidious things,” added Dr. Weinberg to it. “Women spend a lot more time making sure they don’t get breast cancer rather than dealing with their cholesterol and blood sugar problems.”
Women may also be more likely to dismiss early symptoms of heart events as being due to something less serious. “Women may report to their medical providers later for persistent or nonspecific symptoms,” Laura Franey, MD, a cardiologist at Corewell Health, told Health, adding that heart testing and screening may also be limited for women.
Overall, “identifying sex-specific causes for worse heart outcomes in women has been limited,” said Dr. Franey. “More studies are needed to determine why, despite improved outcomes in men, we don’t see similar results in women.”
But dr. Franey pointed out that “identifying gender-specific causes for worse heart outcomes in women is limited,” adding that “more studies are needed to determine why, despite improved outcomes in men, we don’t see similar outcomes in women.”
Related: Study: Insomnia Linked to Increased Heart Attack Risk, Especially for Women
How women can protect their heart health
As researchers continue to try to understand the reasons behind the gender disparity in cardiovascular outcomes, women can take steps to increase their personal awareness of heart disease and support their heart health.
“Patients should be aware of the symptoms of myocardial infarction and seek medical attention when it occurs,” said Dr. Martinho.
The symptoms of a heart attack can look different in women than in men. “Women are more likely to have symptoms other than chest pain than men,” said Dr. Andersen. “They may feel arm, jaw or back pain, a feeling of indigestion, become weak, sweaty or lightheaded. Most know something is wrong.”
But women also need to recognize those symptoms and take action to get help in a timely manner. “Women are less responsive to their symptoms,” added Dr. Andersen to it. “Even if they think they are having a heart attack, they will wait longer before acting on it.”
However, experts emphasize that preventing cardiovascular disease is the first step: “Prevention is key,” said Dr. Weinberg. “You can do so much more for your body when you try to prevent a disease process. Once you get it, it becomes more of a sticky situation.
“Just like with men [women] should try to maintain a healthy lifestyle, which includes regular exercise and a low-fat diet, to avoid the development of serious cardiovascular diseases such as hypertension, obesity, diabetes or high cholesterol, “said Dr. Martinho. Avoiding smoking is also important, she added.
And if a woman has a heart attack or cardiovascular event, she may need additional monitoring. “[Women should] should be monitored and treated aggressively with strict monitoring of blood pressure, cholesterol and sugar levels,” said Dr. Andersen, adding that they should also be referred to a cardiac rehab center and encouraged to actually go.
Despite having this information about women and heart health, much more needs to be done to ensure lives are saved.
“Women’s heart disease is still under-researched, diagnosed and under-treated,” said Dr. Andersen. “We need to study women’s heart disease because it is often different from men’s. We need practitioners to know that women are at higher risk and to aggressively monitor and treat them. And we need to make women aware of their risks so they can practice prevention, treat symptoms and be their own advocate for care.
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Read the original article on Health.