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Heart Health for The Heartland

Myth: men are at greater risk of heart disease than women...Fact: 1 in 3 deaths in women are from cardiovascular disease and stroke.
A recent webcast hosted by HRSA's Office of Regional Operations examined how persistent myths about cardiac health --
especially among women and minorities -- can effect clinical approaches to the prevention and treatment of the disease.

While there has been a marked decline in deaths from cardiovascular disease among men and women in recent years, new research reveals a need for greater clinical sensitivity in diagnosing such cases across discrete populations, according to a HRSA Region 7 webinar earlier this month.

Nearly 50 percent of all Americans have some form of the condition, and risks are highest in racial and ethnic minority populations, reported Cardiologist Annabelle Santos Volgman, M.D., of Chicago's Rush University Medical Center.

Volgman provided a detailed breakdown of the latest research on heart disease, best practices in prevention and treatment, and common clinical myths that continue to complicate diagnoses.

Asians, for example, are long thought to be at lower risk for cardiovascular disease. In fact, research has found that "disaggregated" subpopulations of people from Indian, Filipino and Vietnamese backgrounds are at much higher risk than non-Hispanic whites -- while diabetes is "rampant" among other Asian sub-groups, though the causes are not yet well understood, Volgman said.

Dr. Annabelle Santos Volgman is a widely   published  researcher, Professor of Medi-  cine and Senior Attending Physician at   Rush -- and was selected a Top Doctor for Women in Cardiology by Women’s Health Magazine.
Dr. Annabelle Santos Volgman is a widely published  researcher, Professor
of Medi
cine and Senior Attending Physician at Rush -- and was selected a
Top Doctor for Women 
in Cardiology by Women’s Health Magazine.

Illustrating the consequences of these misconceptions, Volgman gave an overview of women's cardiovascular health trends from 1975 to 2015 – noting that women were thought for decades to be at lower risk for heart disease than men. In fact, they are not, although the myth persists in some quarters.

Changes in medication regimens during the 1980s -– notably, the advent of statins for at-risk men  -– unmasked the fact that women are more vulnerable to smaller and more frequent cardiac events that take a toll over time.

When both genders were treated similarly, rates of the disease plummeted until they were level by about 2010.

"Women were not as well taken care of," Volgman said, based on the notion that men were at greater risk. "When we started doing studies of women," scientists at NIH and elsewhere realized that women were dying at rates similar to men, though their stages of life and symptoms tended to be markedly different.

"Women do have chest pain, they just don't describe it as 'pain' sometimes," Volgman said, noting that generalized weakness and loss of energy are far more telling signs. "Women, generally, don't present with classic symptoms" found in men, leading to decades of undiagnosed heart conditions.

Chart showing heart attack symptoms for women: sweating, shortness of breath, pain in the arms, back, neck or jaw, fatigue, chest pain/discomfort, nausea, and stomach pain.
Unlike the classic symptoms in men -- tightness or pain in the left side of the chest or arm, for example -- women's heart attack
warning signs can be more gen
eralized or subtle and may strike days in advance.

Further, the U.S. also is "leading the pack" among developed countries in maternal mortality – and more than a third of those cases have been linked to underlying heart disease.

"These statistics are scary," she said, noting that obesity, diabetes and elevated lipids are implicated in difficult pregnancies – along with hypertension in African-American women -- and can lead to heart attacks and strokes for up to a year after childbirth.

"We're also seeing higher risks during menopause," she added, and in other stages of women's lives.

View the February 1 webcast, Cardiovascular Disease in Women and Minority Populations.

Date Last Reviewed:  February 2018