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Is heart disease underdiagnosed in women?

Heart disease may be being underdiagnosed in women, and a simple alteration of the perception of the disease may change this fact.

Heart data concept. Copyright: tribalium123 / 123RF Stock Photo, cardiovascular, cardiac
Image credit: tribalium123 / 123RF

Studies have shown that more men die from heart disease than women. In 2017 in India heart disease caused 2.64 million deaths, of which, women accounted for 1.18 million, while men accounted for 1.45 million. Such figures may be causing an issue of perception. While it is true that more men suffer and die from heart disease, this does not discount the women. According to the figure from 2017, women still account for roughly 44 percent of all deaths, however, the image of heart disease only being a major problem among men may be leading to many women ignoring early warning symptoms that could save their lives.

“As seen among many of my patients and their attendants, women even with multiple heart risk factors tend to downplay their symptoms that are obviously related to heart disease,” said Dr. P. Vinodh Kumar, Senior Consultant Cardiologist and Clinical Lead, Department of Cardiology, Prashanth Superspeciality Hospital, Kolathur in comments to the Times of India. “In my practice, the incidence of women presenting with heart attacks is ten percent of total cases and they usually present much later and also tend to self-medicate under assumption that it is probably a gastric symptom. This situation can only be changed by inculcating awareness of early identification of symptoms related to heart disease and it needs to be periodically checked for treating risk factors which majorly need self-care and self-nurturing.”

Heart disease accounted for 28.1 percent of all deaths in India in 2016. The condition is India’s leading cause of death and has been growing in tandem with a rapid shift in lifestyles brought about through India’s rapid industrialisation, increased migration to cities and economic growth over the course of recent decades.

Some risk factors are shared between men and women. High cholesterol, blood pressure and obesity are among the most concerning risk factors. Mental stress, and lack of physical activity are concerns in both genders, but may be playing a more prominent role in women. In addition, risk factors that are unique to women such as low levels of oestrogen post-menopause may be being overlooked. 

Dr. Ganesh Kumar, Head of Department Cardiology, Senior Consultant Interventional Cardiologist, Dr. L.H. Hiranandani Hospital, Mumbai noted, “Culturally I have seen that we are a bit dismissive about a woman’s symptoms and they are brought to health care rather too late. This is more prevalent in large joint families even in affluent classes where the decision maker is the head of the joint family.”

Timing is key, both with heart disease and many other conditions. Early warning signs can potentially be the difference between life and death, for women to be ignoring these early symptoms and foregoing diagnosis is dangerous. More must be done to ensure equity in access to healthcare, and to ensure women are both informed enough to spot the dangers, and that they feel comfortable enough to seek help.

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