Women's symptom profiles often vary markedly from those of their male counterparts. Women with heart disease are up to ten years older than men and present with much less obvious and stereotypical symptoms. Both the general public and medical professionals need to be sensitive to women's CVD symptom profiles and disease progression patterns, as these do not necessarily follow the more widely-known trends of men's.
Women tend to get heart disease later than men due to the cardioprotective effects of oestrogen that plays an important role up until the menopause. However, after the menopause, the risks increase significantly and need to be delicately managed.
In many women, the onset of heart disease is more gradual, accompanied by tiredness, rather than the more commonly-recognised symptoms, such as sudden violent chest pain, that predominate in men. Furthermore, women with CVD are more likely to die or suffer disability from a re-attack or heart failure.
Professor Priori says, "The issue is not simply that men and women are different per se, but rather that there are specific differences between the genders in symptom profiles and responses to treatment that must be taken into proper account".
Women are under-represented
Clinical trials are biased towards men as, to date, women have been grossly under-represented in clinical trial design, enrolment and analysis. This directly affects treatment practices, including recommendations on drug and procedure usage.
Professor Priori states, "We need more women in clinical trials. Cardiovascular disease is the leading cause of death in women and until women are sufficiently represented and analysed in landmark studies, the treatment and medical understanding of women's heart disease will remain substandard".
Women are under-treated