In a new scientific statement, published in Circulation, the American Heart Association (AHA) advises that the causes, symptoms, and outcomes of myocardial infarction may be different in women compared with men. It adds that these differences are further pronounced in Black and Hispanic women. The statement is the first scientific statement from the AHA on myocardial infarction in women.
According to the statement, women tend to have less severe blockages in their coronary arteries than men but blood flow to the heart is still decreased because the vessels are damaged. Therefore, the result can be the same as for a man who has a severe blockage in his artery—a myocardial infarction can occur. The statement notes that if doctors do not correctly diagnose the underlying cause of a woman’s myocardial infarction, they may not be prescribing the right type of treatments.
It adds that while chest pain or discomfort is the most common symptoms of myocardial infarction for both sexes, women are more likely to have atypical symptoms such as shortness of breath, nausea or vomiting, and back or jaw pain. Additionally, risk factors for myocardial infarction may also differ in terms of degree of risk. For example, hypertension is more strongly associated with myocardial infarction in women than it is in men, and a young woman with diabetes has a four to five times’ higher risk of heart disease than a young man.
Regarding racial differences, compared with white women, black women have a higher incidence of myocardial infarction in all age categories and young black women have higher in-hospital death rates. Additionally, black and Hispanic women tend to have more heart-related risk factors such as diabetes, obesity and high blood pressure at the time of their myocardial infarction compared with non-Hispanic white women.
Understanding gender and ethnic differences can help improve prevention and treatment among women. Lead author of the statement Laxmi Mehta, (a non-invasive cardiologist and director of the Women’s Cardiovascular Health Program, The Ohio State University, Columbus, USA), says: “Women should not be afraid to ask questions—we advise all women to have more open and candid discussions with their doctor about both medication and interventional treatments to prevent and treat a heart attack. Coronary heart disease afflicts 6.6million American women annually and remains the leading threat to the lives of women. Helping women prevent and survive heart attacks through increased research and improving ethnic and racial disparities in prevention and treatment is a public health priority.”