wear red day 2024: women still underdiagnosed and undertreated with heart disease, stroke

according to the canadian women’s heart health centre, at the university of ottawa heart institute, 24,000 canadian women die of heart disease every year. that’s nearly seven times more deaths than from breast cancer.

the heart and stroke foundation reports that heart disease and stroke is the number one cause of premature death in women in canada and early signs of a heart attack were missed in 78 per cent of women . and women who have a heart attack are more likely to die or suffer a second heart attack compared to men. feb. 13 is “wear red day” in canada to create awareness and push for change.

one study, however, found that women complaining of symptoms consistent with heart disease recognition, including chest pain, were twice as likely to be diagnosed with a mental illness when compared to men who presented with identical symptoms.

the symptoms for women can also be subtle during a heart attack, including “indigestion, shortness of breath and back pain, sometimes even in the absence of obvious chest discomfort,” says dr. lili barouch, director of the johns hopkins columbia heart failure clinic.   and a report by the american heart association revealed that heart attacks are deadlier in women who don’t exhibit chest pain, in part because it plays out that patients and doctors take longer to identify the issue.

a group of u.s. scientists in 2022 published a study in therapeutics and clinical risk management that looked at the factors that drive women to delay seeking care for their cardiac problems and found the absence of chest pain was a major reason. many of the women reported having either shortness of breath or nausea and indigestion.

now there’s a growing body of work shining a light on what previous male-focused research has not shown – women have their own unique heart disease risk factors and are disproportionately affected by others:

• relatively high testosterone levels prior to menopause
• increasing hypertension during menopause
• pregnancy complications like gestational diabetes
• autoimmune diseases such as rheumatoid arthritis which is more common in women than in men
• stress and depression, also more common among women
• low risk factor awareness, including lack of recognition of many of the above conditions as risk factors for heart disease.

as blacquiere points out, there are different things that women are more susceptible to as they grow older, for example. “so they may be more susceptible to severe strokes when they’re older because of the presence of atrial fibrillation, or abnormal heartache, because there’s a gender component to that.” women often have underlying valvular disease. and new research from the smidt heart institute at cedars sinai challenges conventional wisdom that men are at greater risk of atrial fibrillation, finding that women have a 50 per cent higher risk of developing it than men.

another concern is that more younger women are presenting with classic vacular high-risk factors for heart disease , such as high blood pressure, diabetes and obesity. lifestyle factors play a role here, but what’s becoming more recognized is fluctuating hormones during pregnancy and approaching menopause that impact women’s heart health.