GPs should focus on lifestyle factors to cut heart disease deaths in women

GPs should take a different tactic to tackle cardiovascular disease (CVD) in women than men, experts have warned, amid rising evidence that women are undertreated and more likely to die from the disease.

Fewer women survive CVD and many are not receiving guideline-recommended treatment, experts at the European Society of Cardiology (ESC) congress 2015 in London said.

CVD tends to present later in life for women, and new research has shown that different risk factors make women more likely to experience recurrent cardiovascular (CV) events than men, prompting calls for doctors to take a different approach to tackle the disease in women.

GPs should prioritise improving lifestyle factors such as lack of exercise, diet and smoking in women to reduce their risk, experts said.

CVD is the primary cause of death in women across Europe, claiming the lives of 51% compared to 42% of men.

University of Oxford’s Professor Barbara Casadei said it was important to break down the common misconception that CVD is ‘a male disease’.

She said: ‘Heart disease is the same disease across the sexes, but it presents differently in women from men. This is known, but not always appreciated, and so consequently diagnosis of the disease is often missed or delayed.’

Heart disease in women

A Greek study presented at the ESC congress on Tuesday found that there was a ‘clear difference’ in the biggest risk factors for CVD in men and women.

Researchers looked at data for over 2,000 patients in Greece from 2003/4 following a CV event for 10 years. They then used a statistical programme to determine the most likely cause of recurrent CV events throughout this period.

They found that although survival after the first CV event is high, the recurrence of CV events after this was also high.

The leading causes in men were diabetes and smoking, with diet and inactivity having less of an impact.

But in women, modifiable lifestyle factors such as physical inactivity, low adherence to a healthy Mediterranean diet and recurrent smoking were the biggest factors.

Educate patients

Professor Chris Gayle, from the University of Leeds, said the results made it clear that ‘a different tactic’ was needed to take on the disease in women.

‘I think the most important thing here from a primary care perspective is greater awareness,’ he told GPonline. ‘The study clearly showed that the highest ranking predictors of recurrent CV events were different between males and females and it is lifestyle factors among females which are more important.

‘So from a primary care point of view, [we need] greater education in patients, perhaps greater screening, follow-up clinics for patients that have had CV events and addressing not only their medications but their lifestyle factors as well.

‘After a heart attack, even though the treatment is excellent and mortality very low – what we have created is a survivorship, a legacy of on-going CV patients who are surviving.'

In the UK, CVD is responsible for close to a third (28%) of all deaths, which is comparable to the number of cancer deaths.

In 2009/10, this burden was responsible for 150,000 UK hospitalisations, and incurred costs of £3.6bn of direct healthcare expenditure.

Picture: iStock

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