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Heart Disease: Are Women Tougher?

Women may be tougher than men when it comes to handling heart disease, according to a new study.

Researchers at the University of Michigan compared 142 women and 348 men with heart disease.

The women's hearts were in rougher shape, but women and men gave themselves equal ratings for their heart disease's severity.

That "toughness" could be risky.

"If women do not perceive that their cardiac disease is severe, then they may not pursue medical evaluation, treatment, or rehabilitation," write David Nau, PharmD, PhD, and colleagues.

The report appears in The American Journal of Medicine.

Unequal Care

Heart disease is a leading cause of death for men and women alike. Studies have repeatedly noted differences in heart care for women and men.

For instance, a study presented in November showed that women at high risk of a heart attack were less likely than their male peers to get certain heart tests and treatments.

In September, a study done in Dublin, Ireland, showed that when men and women went to Dublin emergency rooms because of possible heart attacks, women waited longer for evaluation and care.

Last January, British researchers reported that women's heart attacks are less likely to be diagnosed than men's heart attacks.

Safeguarding Your Heart

Many heart risks can be prevented or treated. See your doctor for any questions about your heart's health, and call 911 immediately at any sign of a heart attack.

For both men and women, heart attack symptoms can include:

  • Squeezing chest pain or pressure
  • Shortness of breath
  • Sweating
  • Tightness in chest
  • Pain spreading to shoulders, neck, arm, or jaw
  • Feeling of heartburn or indigestion with or without nausea and vomiting
  • Sudden dizziness or brief loss of consciousness

    Subtle heart attack symptoms that may occur, especially in women, include:

  • Indigestion or gas-like pain
  • Dizziness or nausea
  • Unexplained weakness or fatigue
  • Discomfort or pain between the shoulder blades
  • Recurring chest discomfort
  • Sense of impending doom

    However, both men and women can experience "atypical" heart attack symptoms. So always call 911 and let an expert figure out whether a heart attack has occurred.

    It's a timely topic, as other researchers recently reported that December is especially deadly for senior citizens' heart attacks.


  • Downplaying Heart Disease

    The reasons for the differences aren't totally clear. Doctor's attitudes and lack of awareness have been "leading suspects," says Kim Eagle, MD, in a news release.

    However, "no one has examined differences in [men's and women's] attitudes," Eagle continues. Eagle is a professor of internal medicine and the clinical director of the University of Michigan's Cardiovascular Center.

    "Although our study cannot prove that women's 'toughness' influences their tendency to seek and accept aggressive care for their heart problems, we hope it prompts further investigation of this question," Eagle says.

    Heart Patient Survey

    The researchers mailed surveys to about 1,200 people seen at the University of Michigan Hospital from 1999-2002 for problems including heart attacks and unstable angina (chest pain).

    Only 40% of the patients responded. Men and women were equally likely to respond, and they seemed similar to people who didn't respond, the researchers note.

    Male and female participants had similar backgrounds, in terms of race and their type of heart problem. However, the women tended to be older, less educated, had more heart symptoms, and took more prescription drugs.

    Patients completed several surveys. In one survey, they rated the severity of their heart disease on a five-point scale ranging from "very mild" to "very severe."

    About 42% of men and women called their disease "very mild" or "mild." Equal percentages opted for more severe categories.

    Important Implications

    "The implications of the findings of this study are not trivial," the researchers write.

    "It is known that women delay seeking medical care when they experience symptoms of acute [sudden] coronary syndrome. Women are also less likely to be selected for invasive treatments such as angioplasty or coronary artery bypass graft surgery," they continue.

    "The fact that women perceive the severity of illness to be no greater than men do, even when the clinical evidence suggests they have more severe disease, may help explain some of the variation in care-seeking behavior and treatment decisions between men and women," the researchers conclude.

    Sources: Nau, D. The American Journal of Medicine, November 2005; vol 118: pp 1256-1261. WebMD Medical News: "Women With Chest Pain Get Less Treatment."
    WebMD Medical News: "Women Wait Longer for Heart Attack Treatment." WebMD Medical News: "Women's Heart Attacks Often Undiagnosed." WebMD Medical News: "Men vs. Women: Confusion Over Heart Symptoms."
    WebMD Medical News: "December Deadlier for Heart Attacks."
    WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Heart Disease: Heart Attacks." News release, University of Michigan Health System.

    By Miranda Hitti
    Reviewed by Louise Chang, MD
    © 2005, WebMD Inc. All rights reserved

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