Cardiovascular disease is the leading cause of death in women yet most women believe that they are more likely to die from breast cancer than heart disease. Women usually develop heart disease 10 years later than men do but this advantage is lost in Maori women and in women who develop diabetes. Women are more likely to present with atypical symptoms but central chest tightness remains the most common presenting symptom.
Early research suggests that women delay in presenting for the diagnosis of both angina and acute myocardial infarction and that the delay may be due partly to lack of awareness of their risk of heart disease but also to prior experience of more severe pain surrounding menstruation and child birth. Fewer women attend cardiac rehabilitation despite a demonstrated 25% improvement in survival.
The risk of stroke is higher in women than men, with hypertension the leading underlying cause. Rates of cardiovascular disease in women are increased after menopause but hormone replacement therapy unfortunately increases the risk of heart attack and stroke.
There is a tremendous opportunity in both general and cardiology practice to improve the awareness of women as to their risk of cardiovascular disease, to increase diagnostic rates and to actively manage actively their risk factors.