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When research cardiologists from the Minneapolis Heart Institute Foundation® (MHIF) share the statistics surrounding women’s heart health outcomes and research on women, many people — especially women — are surprised.
For example, did you know that one woman dies from cardiovascular disease every 80 seconds? Yet fewer than one in two women perceive heart disease to be their greatest health threat.
Contrary to popular belief, just as many women as men die from heart disease each year. And, while deaths from heart disease over the past couple of decades had been decreasing for both men and women in high-income countries such as the US, that trend has recently been reversing for both genders.
One of the goals of the MHIF Penny Anderson Women’s Cardiovascular Center is to close the gap that exists from a gender perspective in women’s heart disease outcomes. Over the last couple of decades, mortality rates have improved for men, but the same isn’t true for women.
These gaps exist because of how significantly cardiovascular research for women lags behind that for men. While it has long been assumed that treatment modalities found to be safe and effective for men are also effective for women, this is not necessarily the case. Unfortunately, less than three in 10 women are represented in clinical research trials.
“Until recently, there had been little effort to ensure that women made up roughly half of all research participants,” said Dr. Courtney Jordan Baechler. cardiologist, researcher and medical director, emerging science centers at MHIF. “Even then, the data that was collected for women was combined with the men’s research data, missing the unique characteristics of the women participants. To address this, we encourage women to consider the benefits of additional options available through research studies and we have studies specifically focused on cardiovascular conditions that are more likely to affect women.”
In the US, women have historically been under-represented and often excluded from clinical trial participation. Back in 1977, the Food and Drug Administration (FDA) recommended that women of childbearing potential should be excluded from phase 1 and early phase 2 drug trials because of drug-related incidents, including the tragedy conferred by giving thalidomide to pregnant women. This policy resulted in the broad exclusion of women from clinical trials and contributed to their subsequent frequent under-representation. It wasn’t until the mid-1980s when the FDA began to change its policies to include women in clinical trials, and not until 1993 when the FDA explicitly reversed the recommendation. Still, the enrollment of women in research trials has increased only slowly through today.
Another area that often surprises people is the impact that pregnancy and menopause have on women’s heart health.
“We’ve gone through the last 30 years thinking women are small men, which is not true,” said Dr. Retu Saxena, a cardiologist and MHIF researcher with expertise in women’s heart disease, noninvasive imaging and critical care, as well as specific research interests related to cardiovascular risk factors that emerge during pregnancy. “We have different cardiovascular conditions — and we have pregnancy. What happens to us during pregnancy impacts us later in life and impacts our hearts during pregnancy.”
Pregnancy is often thought of as a woman’s first “stress test” that can unmask underlying heart and vascular problems and future risk. Unique risk factors in pregnancy include conditions such as pregnancy-induced hypertension, preeclampsia and gestational diabetes, which confer a two- to seven-fold risk for women of developing cardiovascular disease.
In menopause, complex hormonal changes take place that increase a woman’s risk for heart and vascular disease. This risk is exacerbated in women who experience menopause between ages 40-44; they are actually 40 percent more likely to suffer from heart and vascular disease, including having a heart attack, severe chest pain or stroke.
There is also a positive reality in this focus on women’s heart health research. There are actions all women can take to address their own heart health, including taking time to move, relax and refocus.
Through the Penny Anderson Women’s Cardiovascular Center, MHIF researchers are working to advance the understanding of heart and vascular disease in women, how to prevent it and how to optimize patient care. Whether you are 18 or 80, the need is clear for all women to understand their risk, take steps to reduce their risk, know heart symptoms to watch for, and help empower other women in their lives to do the same.
Look at our women’s heart health timeline to better understand women’s cardiovascular disease cumulative risk throughout a lifetime and then learn the steps you can take to care for your heart.
