Recent research suggests that ignoring gender-specific risk factors for heart disease has led women to a higher risk of dying from heart failure than men.
A journal published in Nature medicine reveals an alarming failure to successfully treat cardiometabolic disorders, such as diabetes, heart disease and stroke, in women.
The authors urge health services to consider the biological differences between men and women when treating heart disease.
The review, by Professor Eva Gerdts, of the University of Bergen, in Norway, and Professor Vera Regitz-Zagrosek, of the Charité Universitätsmedizin Berlin, in Germany, compares the risk factors common to both sexes.
"Men and women have different biologies, which results in different types of the same heart disease. It is time to recognize these differences. "
Eva Gerdts
The authors summarize the results of more than 18 major studies that have explored the causative factors of heart disease in each gender.
The overwhelming conclusion is that women are more at risk of being abused because health care professionals fail to identify their own symptoms or risk factors.
Recent research has confirmed fears that the global increase in cardiometabolic disorders is linked to obesity. Meanwhile, new evidence suggests that obesity and associated heart damage occur differently in men and women.
Global figures show that obesity in women is increasing and, as Professor Gerdts's review explains, women store fat differently than men. The mechanisms behind this process combine to create an increased risk of type 2 diabetes and heart disease.
"If we see this from a lifespan perspective, we can see that obesity increases with age and that this trend is greater for women than for men. Obesity increases the risk of high blood pressure by a factor of three. This, in turn, increases the risk of heart disease, "says Professor Gerdts.
The hormone estrogen prevents metabolic syndrome by preventing the formation of connective tissue in the heart. It also helps keep blood pressure stable.
But the decrease in estrogen that occurs during menopause can increase the risk of arterial stiffening and subsequent illness.
This explains an increase in hypertension in women over the age of 60. In men, meanwhile, hypertension is more common before the age of 60.
Socioeconomic status and lifestyle factors also play a role in the cardiovascular risk differentials.
Researchers point out that women worldwide are more likely to have low education, low income and unemployment, and that studies have linked each of these factors to diabetes and depression - two main factors contributing to heart disease.
Meanwhile, the harmful effects of unhealthy habits, such as smoking - which is on the ascend in women - multiply with age. This can lead to high blood pressure, which can cause heart failure if a person is not treated.
"For women, the effects of risk factors such as smoking, obesity and high blood pressure increase after menopause," says Professor Gerdts.Professor Gerdts hopes to inspire the medical community to act; she calls on health care providers to put more emphasis on gender differences when treating cardiometabolic disorders.
"Heart disease remains one of the most common causes of death and reduced quality of life for women. Medically speaking, we still don't know what is the best treatment for heart attack or [heart] failure is in many women. It is an unacceptable situation. "
Eva Gerdts
This study highlights an imbalance in the available research, with the aim of opening the way to other work.
The outlook is promising considering that cardiac arrest - which is more common in men - is now treatable and preventable. If the same resources and research were applied to the factors that put women at risk for heart failure, perhaps equally effective interventions could be developed in the near future.
In the meantime, it is important that providers help women in high-risk groups lower their blood pressure, reduce the risk or the effects of obesity, and leaving smoke at the top of their 2020 goal list, if necessary.
