- Researchers say younger women tend to have worse outcomes after having a heart attack than younger men.
- They add that younger women are also more likely to return to the hospital in the year following a heart attack.
- Experts say among other factors younger women tend to wait longer to seek treatment after experiencing heart ailments.
Younger women who have had a heart attack have more adverse outcomes and are more likely to return to the hospital in the year following their heart attack than men of a similar age.
That’s according to a study published today in the Journal of the American College of Cardiology.
The researchers used data from the VIRGO study, which provides observational information on the treatment and outcomes of heart attacks in people 18 to 55.
In this study, the researchers looked at the health information of 2,985 people – 2,009 women and 976 men. The average age was 47.
They reported that for all-cause hospitalizations within one year of discharge, nearly 35% of women were hospitalized again, compared to 23% for men.
The researchers used any hospital or observation stay longer than 24 hours. The most common cause of re-hospitalization was heart attack and chest pain.
In addition, women who had heart attacks had more adverse outcomes than men.
The women in the study had a higher prevalence of co-morbidities, including obesity, congestive heart failure, previous stroke, and renal disease.
The younger women were more likely to be low-income, have a history of depression, and have significantly worse health status than the men in the study.
The women also tended to wait longer before seeking medical attention after experiencing chest pain, arriving at the emergency room an average of more than 6 hours from the start of their symptoms.
“There are many reasons women are more likely to delay seeking care for heart attack symptoms when compared to men,” said Dr. Anais Hausvater, the clinical instructor in the Department of Medicine in the Leon H. Charney Division of Cardiology at NYU Grossman School of Medicine as well as a cardiologist at NYU Langone Heart in New York.
“Gender-based roles such as caregiving and household responsibilities tend to make women more likely to delay care,” she added.
“In addition, women are less likely than men to attribute their symptoms to their heart,” Hausvater told Medical News Today. “This is likely due to lower awareness that cardiovascular disease is common among women. In fact, it is the number one killer of women. In a
The women in the study were more likely to have:
- non-ST-elevation myocardial infarction (NSTEMI), which is caused when the heart doesn’t get enough oxygen
- myocardial infarction with nonobstructive coronary arteries (MINOCA)
The women with MINOCA were likelier to be non-Hispanic Black, smokers, have lower education status, have the lowest proportion of previous coronary artery disease, and have the lowest treatment satisfaction than those with obstructive coronary artery disease.
They had more extended hospital stays and less often received guideline-recommended medical therapies, including aspirin, statins, beta-blockers, and angiotensin-converting enzyme inhibitors (ACE inhibitors.)
The researchers said their findings demonstrate the need for secondary preventative strategies to reduce coronary-related hospitalizations.
They suggest further research is needed into the causes of non-cardiac hospitalizations as gender disparities were more apparent in this area.
To lower the risk of returning to the hospital, women need information, experts say.
“If hospitalized for a heart attack, a woman should ask: what is my precise diagnosis, what medications are being prescribed and why, how, when, and with whom should I follow up?” said Dr. Sarina Van Der Zee, a cardiac electrophysiologist and cardiologist at Providence Saint John’s Health Center in California.
Heart disease is the
“Traditional risk factors of high blood pressure, cholesterol, diabetes mellitus, smoking, and family history typically present later in women than men but may be more severe when they present earlier,” Van Der Zee told Medical News Today. “Other risk factors more common in women include autoimmune disease and some types of vascular disease. There are also psychosocial and demographic factors that make it harder to ensure prompt evaluation and follow-up visits.”
- Coronary artery disease is characterized by plaque in the walls of the areas. Women are more at risk for this after menopause because of hormonal changes.
- Arrhythmia, when the heart beats irregularly. It can be too slow, too fast, or have other irregularities.
- Heart failure – occurs when the heart can’t pump enough blood to support the organs in the body.
“There is a spectrum of symptoms of heart attack that include the typical ‘elephant-on-the-chest’ type of pain, as well as nausea, vomiting, shortness of breath, sweating, and others,” said Van Der Zee. “The non-typical symptoms are less well-known.”
Some health conditions specific to women can also contribute to the higher risk of cardiovascular disease.
“There are certain risk-enhancing factors specific to women and are associated with an increased risk of incident atherosclerotic cardiovascular disease among women,” Hausvater said. “These factors, if present, would favor more intensified lifestyle interventions and earlier consideration of cholesterol-lowering medications. These factors include a history of adverse pregnancy outcomes (preeclampsia, gestational diabetes, gestational hypertension, preterm birth, and delivering a low-for-gestational-age infant), premature menopause, and polycystic ovary syndrome. Other risk enhancers more common among women include inflammatory disorders such as lupus or rheumatoid arthritis and chemotherapy or chest radiation for breast cancer.”
There are ways you can lower your risk of heart disease, according to the National Library of Medicine:
- Control your blood pressure
- Keep triglyceride and cholesterol levels under control
- Maintain a healthy weight
- Eat a diet with plenty of fresh fruits, vegetables, and whole grains
- Get regular exercise
- Limit alcohol consumption
- Don’t smoke
- Manage stress
- Manage diabetes if you have it
- Get enough sleep
Hausvater offers thoughts on what women should take away from this study:
- Heart attack prevention is essential. If you have had a heart attack or have risk factors for heart disease, it is important to follow closely with your doctor to ensure you are on the proper medications and following a heart-healthy lifestyle.
- If you have already had a heart attack, follow up closely with your doctor after leaving the hospital. If you experience any symptoms of chest pain or shortness of breath, or symptoms like what you had with your heart attack, see your doctor, or go to the hospital immediately.
- Young women have heart attacks, too. Public awareness of this fact is essential. If you have symptoms that you think might be related to a heart attack, even if you are unsure, do not delay seeking care.
- Psychosocial factors like depression and anxiety might be more important risk factors for heart disease among women than men. Addressing and treating these psychosocial risks is essential, especially among women.