Absent: Medical Recognition of Female Heart

"The most common type of heart failure, which is increasing, we don't have a treatment for it. We need it, because it's predominantly a female disease."
“If I’ve got a woman or a man who has reduced heart-pumping function, I have five guideline-based treatments for them plus a bunch of extras that I can apply if I need them. I’ve got nothing based on guidelines or research for the predominant women-type of heart failure.”
"It [gender differences in heart disease is] under-researched and under-funded. It's a huge cost sink. If we could just prevent or delay it, it would save us money."
"We're [women] at risk. We cannot let our foot off the gas pedal. [Women] need to step up. They need to own this disease. Women's health should be defined as women's heart health. They [women] put themselves last. What we need to do is flip that paradigm, so that women put themselves first, so the can do all those other things [such as looking after everyone dependent on their presence]."
"[Governments and society as a whole] need to value women more and invest."
Dr. Sharonne Hayes, professor of medicine and cardiovascular diseases, Mayo Clinic

Dr. Sharonne Hayes was the keynote speaker at the Canadian Women's Heart Health Summit at the Westin Hotel in Ottawa Thursday April 14, 2016. Tony Caldwell

"[Appearing at the summit are] some of the best thought leaders in Canada to focus on the urgent issue of women's heart health."
"The scary truth is that although nine in ten women have at least one risk factor for heart disease and stroke, we perceive it as a less significant health risk -- less significant, frankly, than cancer."
Colleen Johnston, co-chair, Ottawa summit on women's heart health

And so, in a concerted effort to fill that gap in medical science's attention and understanding that symptoms of heart disease and failure in women bears little resemblance to that recognized in men, the University of Ottawa Heart Institute and the Heart and Stroke Foundation of Canada brought together leaders in North American heart research focusing on women.

It is past time, after all, since cardiovascular disease is now recognized as the leader in death of women around the world, where one in three women will die resulting from heart disease or stroke. The problem is that such illnesses are too often undetected until it is too late, the result of gaps in prevention, diagnosis and treatment.

According to Dr. Hayes, keynote speaker at the three-day summit, between 1984 and 2012, greater numbers of women than men died of cardiovascular disease in the United States. By 2013 the number of female deaths began to diminish, falling slightly under the total figure for men. But Dr. Hayes sees that trend backtracking as increased rates of obesity and diabetes once again pose a threat to that progress.

Conventional medical understanding was that heart failure was commonly attributed to a decline in the capacity of the heart to pump blood. Then it was understood that the type of failure most commonly seen in women -- characterized as heart failure with preserved ejection fraction -- is actually caused by complications that ensue when the heart relaxes between beats. That leads to elevated blood pressure that has a deleterious impact on the heart.

Women, in the past, were informed all too often by their doctors that they needed o improve themselves physically, lose weight, become more active, when they presented with complaints of shortness of breath or swelling. Echocardiogram results failed to show any reduction in their heart's pumping function. "Now we know it's a real thing", said Dr. Hayes, but the reality is there is no single drug to treat the symptom.

The advice given women was good advice; to remain active and to eat sensibly to help avoid future problems with the heart. But when women presented with those symptoms it was really too late for the advice, good as it was; the symptoms had to be understood and the condition diagnosed and treatment correctly prescribed. And only then should further preventive action be recommended.

It was stressed to those at the summit that despite the many sex and gender differentials in heart disease, little research has been explored to come up with some answers. And women need to become more involved themselves in their condition and what they can do to avoid heart problems from arising to begin with through lifestyle changes. While most women understand that smoking can cause lung cancer, they fail to understand that the heart too is badly affected by smoking.

"[Women will] get their annual mammogram but they won't get their cholesterol checked or report symptoms. In the U.S. about 40,000 women die each year of breast cancer. Half a million women die of cardiovascular disease. If women paid half the amount of attention to their cardiovascular health as they pay to their breast health we'd have a huge increase in cardiovascular health", advised Dr. Hayes.

Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

• Neck, jaw, shoulder, upper back or abdominal discomfort.
• Shortness of breath.
• Right arm pain.
• Nausea or vomiting.
• Sweating.
• Lightheadedness or dizziness.
• Unusual fatigue.     Mayo Clinic.org