By Amy Isler, RN, MSN, CSN
Fact checked by Nick Blackmer
t
SDI Productions / Getty Images
Key Takeaways
A review found that women with heart disease are more likely to receive intense treatment when their physician is also a woman compared to when they are seen by a male doctor.
When women have heart attacks they frequently exhibit atypical symptoms or no symptoms at all. As a result, women may not be diagnosed and treated soon enough to avoid negative health outcomes.
Research and medical training need to account for the gender differences in cardiovascular disease and all health conditions.
A review published in the Journal of the American College of Cardiology found that women with heart disease are more likely to receive intense treatment when their physician is also a woman compared to when they are seen by a male physician.1
The level of treatment the women received when they had a doctor who was also a woman resulted in better outcomes and reduced mortality rates. These findings are important because cardiovascular disease (CVD) is the number one killer of women,2 and the healthcare disparities experienced by women can greatly affect outcomes.
Heart Disease in Women
The report examined eight past studies on how physician gender affected patient outcomes. The researchers discovered that female patients were less likely to receive the standard of care when treated by a male physician, bringing to light deep-rooted gender disparities in treatment plans.
“Women who look young and healthy are at a disadvantage,” Gina Lundberg, MD, clinical director of the Emory Women’s Heart Center and incoming chair of the Women in Cardiology Section of the American College of Cardiology, tells Verywell. “Physicians frequently pre-determine that they do not have a cardiovascular problem. Everyone needs a full and complete workup regardless of their outside appearance.”
The report highlights the need for change when it comes to women’s health and the biases associated with evaluating women’s symptoms when they seek medical care.
What This Means For You
Women with cardiovascular disease may not receive the same level of care as men. If you're a woman and think you may be experiencing symptoms of CVD, make sure to insist your doctor orders the proper diagnostic testing to rule out the condition, and proper treatment if they find you do have CVD. You can also decrease your risk of CVD by following an exercise routine and eating a heart-healthy diet.
Gender Disparities in Cardiovascular Disease
Cardiovascular disease—an umbrella term describing several diseases of the heart and blood vessels such as hypertension, coronary artery disease, heart attacks, and heart failure—frequently presents differently in women than men.
Symptoms
Research has shown that 64% of women who die suddenly of CVD did not have any prior symptoms.3 Women also may have atypical symptoms of a heart attack and may not have the classic symptom of chest pain.4
Examples of symptoms women might have are:
Nausea or vomiting
Shortness of breath
Dizziness
Sweating
Unusual fatigue
Indigestion
Medication
A systematic review investigating gender differences and medication prescription rates among cardiovascular patients found that women are significantly less likely to be prescribed common CVD medications such as aspirin, statins, and ACE inhibitors (high blood pressure medication) compared to men.
The differences in prescribing practices for women can lead to the progression of cardiovascular disease and even death.5
Marla Mendelsom, MD, a cardiologist and medical director for the program for Women’s Cardiovascular Health at Northwestern Medicine, tells Verywell that studies have shown women experience discrimination when they seek medical care for chest pain. “Women were sent home with Tums while men would receive an EKG, stress test, and be sent to the cath lab," she says.
How to Create Change
As more research highlights the data validating real-world disparities in women’s healthcare, experts are calling for change. The report authors believe that implementing upstream changes in medical training and improving professionals' understanding of gender and racial disparities in healthcare settings will lead to positive change downstream for all women.
The study authors recommend three major changes to help decrease bias in women’s healthcare:
Increasing gender diversity in the physician workforce
Improving gender-and sex-specific medical training
Increase research on the role of gender in patient-physician relationships
The Northwestern Feinberg School of Medicine is ahead of the game when it comes to gender disparity curriculum. Mendelson teaches a class to first-year medical students on the sex and gender differences in cardiovascular disease, which she says the students really enjoy.
The under-representation of women in CVD clinical trials is also an area of healthcare that needs to be addressed.
“All studies should be analyzed for gender and racial/ethnic differences,” Lundberg says. “This means we have to enroll more women and more minorities in clinical trials if we are ever going to get that information. So many of the trials have been 80% white males and so that is not adequate for our diverse community of patients.”
The Go Red For Women Campaign
In 2004, the American Heart Association (AHA) launched the Go Red For Women Campaign to make the public aware that heart disease and stroke are the number one killers of women. The campaign also aimed to catalyze change with the goal of reducing disability and death from CVD by 20% by 2020.
What does it mean to "Go Red?"
The AHA explains that women can take control of their heart health by:
Following an exercise routine
Eating a heart-healthy diet
Visiting the doctor for important tests
Influence others by talking about heart health
The money raised by Go Red for Women fundraising activities goes directly to awareness, research, education, and community programs to help change how society perceives CVD in women.
Lundberg, who is an active advocate of women’s heart health, says that “due to the increased awareness through the AHA Go Red for Women campaign and the development of women’s heart centers around the country, the care is much more appropriate today than it has ever been.”
Sources
Lau ES, Hayes SN, Volgman AS, Lindley K, Pepine CJ, Wood MJ. Does patient-physician gender concordance influence patient perceptions or outcomes? J Am Coll Cardiol. 2021;77(8):1135-1138. doi.org/10.1016/j.jacc.2020.12.031
Centers for Disease Control and Prevention. Table 6. Leading causes of death and numbers of deaths, by sex, race, and Hispanic origin: United States.
Harvard Health Publishing. Gender differences in cardiovascular disease: women are less likely to be prescribed certain heart medications.
Mayo Clinic. Heart disease in women: understand symptoms and risk factors.
Zhao M, Woodward M, Vaartjes I, et al. Sex differences in cardiovascular medication prescription in primary care: a systematic review and meta‐analysis. J Am Heart Assoc. 2020;9(11):e014742. doi.org/10.1161/JAHA.119.014742
By Amy Isler, RN, MSN, CSN
Amy Isler, RN, MSN, CSN, is a registered nurse with over six years of patient experience. She is a credentialed school nurse in California.
Post comments