Heart disease doesn’t discriminate. It is the leading killer of men and women. But when it comes to diagnosing and treating it, there is a gender gap. Heart disease kills more women than men each year. Heart disease strikes women, on average, 10 years later than men. Women are more likely than men to have a second heart attack within one year of their first. Let’s look at possible factors that could lead to women’s heart disease. Women with heart attacks are more likely to die than men and that’s not just older women. Women of all ages are more likely to die. According to one Israeli study that adjusted for age, size and other factors, the death risk for women was 1.7 times that of men. During the past decade, heart attack survival has improved greatly thanks to thrombolytics (clot-buster medication) like TPA and streptokinase. But how often do women get these drugs? In one Washington state study, of 1,078 subjects screened for TPA eligibility, 39 percent of the women were too old, 59 percent had nondiagnostic electrocardiograms and 30 percent came to the hospitals too late. Overall, only 16 percent of the women screened were eligible for TPA, compared with 25 percent of men. Of those eligible women, 55 percent received the drug, compared with 78 percent of the men.
It was not clear as to whether the difference was due to patient or physician refusal, failure of emergency room staff to offer thrombolytic therapy or to other causes. One way women can get the benefit of clot busting drugs is to get to the hospital quicker. Studies have shown that women with chest pain wait too long before heading to the emergency room. (Thrombolytics are 50 percent effective if given within the first hour of having a heart attack but drop to only 20 percent effectiveness if given 2-6 hours later). But does clot busting work better in men than in women? Large Studies have found that women’s survival improves with these drugs, but not to the same extent as men, though it is not known why.
Reasons why women’s heart disease statistics are higher than men’s is explained by Dr. Lili Barouch, Assistant Professor of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, “Women are much more likely to have atypical heart attack symptoms.” “So while the classical symptoms, such as chest pains, apply to both men and women, women are much more likely to get less common symptoms such as indigestion, shortness of breath, and back pain, sometimes even in the absence of obvious chest discomfort.”
Women are caregivers by nature. And that tends to put women on the end of the list, if they are on that list at all. This making women caregivers at increased risk for depression and excessive use of alcohol, tobacco and other drugs. Caregiving can be an emotional roller coaster. On the one hand, caring for your family member demonstrates love and commitment and can be a very rewarding personal experience. On the other hand, exhaustion, worry, inadequate resources and continuous care demands are enormously stressful. Caregivers are more likely to have a chronic illness than are non-caregivers, namely high cholesterol, high blood pressure and a tendency to be overweight. Studies show that an estimated 46 percent to 59 percent of caregivers are clinically depressed.
What to do with all this information? Listen to your body. It’s speaking to you. Don’t wait until you’re flat on your back to listen. You can prevent and control heart disease, but you have to be onboard with putting yourself first. It’s okay to ask for help. It’s okay to take a break. Your family would rather have you alive with them than anything you could possible do for them.