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International Women's Day 2009

Gender differences in cardiology: Looking back - and ahead - on Women's Day

International Women's Day will be celebrated by women throughout the world on Sunday, 8 March. This day is a possibility to present the achievements of women worldwide, however, it is also an occasion to point out that nowhere in the world women can claim yet to have the same rights, opportunities or treatment as men.

Even in the world of cardiology gender differences can be found - there is still a disturbing gap in the knowledge, understanding, and general awareness of cardiovascular disease in women.

Cardiovascular disease (CVD) is the primary cause of death in European women. Each year it kills a higher percentage of women (55%) even than men (43%) and more than all cancers combined. Yet many members of the medical community are unaware that the risk factors for women are different than for men or that treatment should vary according to gender.

Women and Cardiovascular diseases

  • Women are equal: The under-estimation of the impact of CVD in women is not confined to the public. Medical professionals equally need to improve the screening, diagnosis, treatment and follow up of women with CVD and its underlying risk factors
  • Women are different: presentation, progression and outcomes of CVD in women do differ from those in men and Women tend to get heart disease later than men 
  • Women are under-represented: women have been grossly under-represented in clinical trial design, enrolment and analysis - something that affects treatment practices
  • Women are under-treated: women are being treated as if they are men, despite the notable differences in their disease elements

Ever since 2005, women and cardiovascular disease have been debated at the European Society of Cardiology (ESC) when the "Women At Heart" initiative was started to raise awareness on this topic and to improve the quality of care for women with CVD. Numerous sessions and articles have been fuelling this gender difference debate and various press releases have been published since.

Take a look back and find some of the press releases issued by the ESC related to gender differences:

  • Cardiovascular disease (CVD) is the primary cause of death in European women. It kills a higher percentage of women (55%) even than men (43%) and more than all cancers combined. With the "Women at Heart" initiative the ESC showed its commitment to improve heart health for women.
  • Gender differences in myocardial remodelling: Many of the original studies tended to include more men and to ignore the women. The general assumption that women were less likely to be affected of CVD has prompted concerns that women are treated less optimally, diagnosed later, misdiagnosed or not treated as aggressively as men.
  • Gender disadvantages: Women with MI are usually diagnosed late during the course, are often misdiagnosed at first, are less likely to receive optimal medical care, and in many series their crude mortality is higher than men.
  • Gender differences in medical care and survival after MI: Disparity in care and outcome after AMI: While men and women have a similar in-hospital death rate following acute MI, women with STEMI had an adjusted mortality rate almost twice as high as men. These differences were associated with a lower likelihood of reperfusion therapy in women. Women are treated less intensively in the acute phase. 
  • Drug treatment influenced by gender: A study in European Journal for Heart Failure (EJHF) reports that “the use of evidence-based treatments appears to be imbalanced according to the gender of the patient”. Female patients were less frequently treated with guideline-recommended medications and doses were lower in female than in male patients.