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CVD the top cause of death in women

Cardiovascular disease (CVD) kills 51% of women in Europe and breast cancer kills 3%, bucking the misperception of CVD as a man’s disease, according to a recent call for women to reduce their risk from the European Society of Cardiology (ESC).

In contrast to popular misconceptions, the ESC statement states that:

•    CVD is the main cause of death in women in all countries of Europe1

•    CVD causes 51% of deaths in women and 42% of deaths in men in Europe2

•    CVD kills 51% of women in Europe and breast cancer causes 3% of deaths2

•    The risks of smoking are higher in women because women metabolise nicotine faster, especially those taking oral contraceptives3

•    Type 2 diabetes doubles CVD risk in men but more than triples the risk in women4

•    Women are more likely to be severely disabled after a stroke than men.5

Dr Susanna Price (Royal Brompton Hospital, London)

Dr Susanna Price (Royal Brompton Hospital, London)

ESC spokesperson Dr Susanna Price (Royal Brompton Hospital, London) said: “CVD is still largely considered a man’s problem with breast cancer commonly perceived as the greater issue for women. However, CVD is the top killer of women in Europe, resulting in 51% of deaths compared to 3% caused by breast cancer.”

She added: “Women’s risk of heart disease tends to be underestimated by both the public and the medical profession because of the perception that oestrogen protects them. In reality this just delays the onset of CVD by 10 years. The result is that women’s risk factors are left untreated, leaving them more vulnerable to heart attack, heart failure and sudden cardiac death when the protection fades after menopause.”

“Another reason CVD is under-recognised and undertreated in women is that they can have different or atypical symptoms,” said Dr Price. “Instead of chest pain, women having a heart attack may experience nausea/vomiting, shortness of breath, jaw pain, fatigue, palpitations, syncope (fainting) or cardiac arrest. They need to call the emergency number urgently as soon as the symptoms of a heart attack or stroke start.”

Women are less likely to receive proven therapies than men, including aspirin, statins, coronary revascularisation after an acute coronary event and oral anticoagulants to prevent stroke when they have atrial fibrillation, despite their higher risk, the statement highlights.

Women may respond differently to therapy because they have different hormone levels, lower body weight and a higher percentage of body fat. However, Dr Price said: “In many cases the safety and effectiveness of treatments in women are unknown because they have been tested mainly in men. Clinical trials are needed that include only women and/or more equal proportions of both sexes.”

“CVD is by far the biggest cause of death in women but is still underestimated as a health problem for them. Greater awareness is needed by women and the medical profession to ensure that women reduce their risk factors and decrease their chances of having a heart attack and stroke,” she concluded.

References

1. European cardiovascular disease statistics 2012. European Society of Cardiology 2012. Available from http://www.escardio.org/about/what/advocacy/EuroHeart/Pages/2012-CVD-statistics.aspx

2. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. Euro Heart J 2014;35:2950–9. http://dx.doi.org/10.1093/eurheartj/ehu299

3. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). Euro Heart J 2012;33:1635–701. http://dx.doi.org/10.1093/eurheartj/ehs092

4. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Euro Heart J 2013;34:3035–87. http://dx.doi.org/10.1093/eurheartj/eht108

5. Cardiovascular diseases in women: a statement from the policy conference of the European Society of Cardiology. Euro Heart J 2006;27:994–1005.

Published on: March 27, 2015

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