Heart disease is the leading cause of death for women in the United States, but the telltale signs of heart attacks in women can often go unnoticed—or end up mistaken for other health problems. That’s what has prompted a new American Heart Association (AHA) report, which serves as a reminder that women’s symptoms of a heart attack, as well as their outcomes, differ from men in important ways.
Heart disease is “an equal-opportunity killer,” the researchers write in the journal Circulation.
Women are more likely to experience symptoms like nausea, shortness of breath, as well as back and jaw pain, rather than the more commonly accepted symptoms of crushing chest pain. Because of that, the AHA statement authors say, doctors may not correctly identify the disease in women, resulting in improper treatment. Heart disease in black women is especially underdiagnosed and undertreated.
The paper highlights how the risk factors for women differ as well. Young women with type-2 diabetes, for instance, face a heart disease risk that’s four to five times greater than men’s. Evidence is mounting that psychological stress can increase the risk of heart disease—something that appears to affect women more than men.
Women are also underrepresented in clinical trials for heart disease, the authors note. They generally make up about 20% of the people enrolled, and even when women are included in trials, researchers often do not parse out the gender-specific data that could deepen scientists’ understanding of how the disease affects women.