Gender Gap in Heart Attacks

As a result of lack of awareness for heart attack symptoms in women, coronary heart disease kills twice as many women in the UK as breast cancer, ONS data shows.

It starts with slight pressure in your upper body - you might vomit, get nauseous, or wet your shirt with cold sweat. And then it gets worse: you feel like an elephant is crushing on your chest. This is what men experience when having a heart attack; not many know however that this medical emergency manifests itself differently in women.

Data from the Office of National Statistics shows that in 2021, coronary heart disease killed more than twice as many women in the UK as breast cancer. Moreover, one in 14 women die from the disease. According to a report by the British Heart Foundation, women are 50 percent more likely to receive a wrong initial diagnosis for heart attack than their male counterparts, increasing the risk of death by as much as 70 percent. The same study also estimated that more than 8200 deaths among women who were hospitalised with a heart attack in England and Wales could potentially have been prevented had they received care equal to that of men.

The study concluded that women were 2.7% less likely to be prescribed statins and 7.4% less likely to be prescribed beta blockers when leaving the hospital, despite their proven benefit of lowering the risk of a subsequent heart attack or stroke. 

While men often suffer from chest pain that feels like a crushing weight on the chest, women are more likely to have subtler symptoms for three or four weeks before a heart attack. They may experience some warning signs that are uncommon for their male counterparts: nausea, unusual fatigue for several days, anxiety, and sleep disturbances. 

Because of this, women are at risk of not being given the proper support or care. Data from the 2019 Global Burden of Disease Study shows that 35 percent of all deaths of women worldwide are caused by cardiovascular disease. That year, coronary heart disease was the single biggest killer of women worldwide. Lack of awareness for heart attack symptoms in women leads to inequalities in healthcare, with health risks for heart disease being far more deadly for women than men.

Dr Sarah Holle at Copenhagen University Hospital analysed in her study how women with chest pain were more likely than men to wait over 12 hours before seeking medical help. Dr Holle recognised that women with heart problems are prone to displaying symptoms unspecific for their male counterparts: nausea, vomiting, coughing, fatigue, and pain in the back, jaw, or neck:

“This might be one reason why more women than men in our study were initially admitted to a local, rather than specialist, hospital. Increased recognition that women may have symptoms other than chest pain could minimise delays in diagnosis and treatment and potentially improve prognosis.”

Moreover, Dr Holle added that “treatment guidelines are based on studies which primarily enrolled men. Further research is needed to determine whether women and men with cardiogenic shock might benefit from different interventions.”

A 2021 report by The Lancet Women and Cardiovascular Disease Commission says that cardiovascular diseases in women remain “understudied, underrecognised, underdiagnosed and undertreated.”