Emphasis Needed on CVD Prevention, Treatment in Women

Women and physicians do not give enough importance to cardiovascular disease in women, and a social stigma regarding body weight may be a primary barrier to these important discussions, according to research published in the Journal of the American College of Cardiology.

“Increasing awareness of CVD in women has stalled with no major progress in almost 10 years, and little progress has been made in the last decade in increasing physician awareness or use of evidence-based guidelines to care for female patients,” said Bairey Merz, director of the Barbra Streisand Women’s Heart Center in the Cedars-Sinai Heart Institute and the study’s lead author.

For the study, researchers from the Women’s Heart Alliance interviewed 1,011 US women aged 25-60 years and collected physician survey data from 200 primary care physicians and 100 cardiologists. The goal of the surveys was to determine knowledge, attitudes and beliefs regarding heart disease in women.

Researchers found that 45% of women were unaware that heart disease is the number one killer of women in the US. Awareness level was lower in women with lower levels of education and income and in ethnic minorities. Nearly 71% almost never brought up the issue of heart health with their physician, assuming their doctor would raise the issue if there was a problem.

However, physicians were more likely to discuss cardiovascular health if prompted by the patient or due to the presence of a risk factor.

Physicians often did not discuss CVD because the patient had a more immediate health issue or did not fully report their symptoms, indicating that prevention prior to symptoms was not a priority. Women who knew someone with heart disease were more likely to express concern and bring this issue up with their physician or to discuss heart disease with a friend thought to be at risk for having or developing heart disease.

While a majority of women reported having a routine physical or wellness exam in the past year, only 40% reported having a heart health assessment. Many women reported being embarrassed or overwhelmed by their heart disease and many also cited difficulties in losing weight or finding time to exercise. Only 22% of primary care physicians and 42% of cardiologists felt well prepared to assess cardiovascular risk in women. Additionally, only 16% of primary care physicians and 22% of cardiologists fully implemented guidelines for risk assessment.

“These findings suggest a need to destigmatize CVD for women and counteract stereotypes with increased objective risk factor evaluation education to improve treatment by physicians,” Merz said.  “National action campaigns should work to make cardiovascular disease ‘real’ to women and destigmatize the disease by promoting the use of cardiovascular risk assessment to counter stereotypes with facts and valid assessments.”