Over 1 million females in Australia are living with cardiovascular disease (CVD), yet it remains underdiagnosed, under-treated, and under-researched in women.
As a young woman, I didn’t fit the stereotype of a typical heart disease patient, so my symptoms and experiences were often overlooked. Born with heart disease, I often felt like an outlier as I navigated my way through Australia’s healthcare system.
CVD is a broad term that refers to many different conditions that affect the heart, and the disease doesn’t discriminate. It can develop in men and women, young and old. However, CVD is often thought of as a men’s health issue, because we often hear stories about how the disease affects a significant number of men, particularly at younger ages.
By ignoring the unique impact that heart disease has on women, we overlook around 10% of women in Australia living with the condition. While this bias is often the product of systemic and cultural biases that affect decision-making, rather than intentional discrimination, the result is that much of our knowledge of heart disease is based on research conducted primarily among men, with women underrepresented and excluded from cardiovascular clinical trials. This lack of representation makes it difficult to measure the safety and efficacy of therapies for women, identify sex-specific differences in important outcomes, and develop strategies for the prevention and management of CVD in women.
What we do know is that some aspects of CVD prevention, treatment, and management are unique to women. Women have a greater risk of heart attack than men due to established risk factors, such as diabetes, smoking and high blood pressure. Conditions specific to women, such as gestational hypertension, gestational diabetes, preterm delivery, premature menopause, and polycystic ovary syndrome, can also increase CVD risk. There is also research emerging about how depression, intimate partner violence, socioeconomic status, and sociocultural roles, are important considerations in the development and manifestation of CVD in women.
Underestimating CVD risk in women can lead to misdiagnosis and delayed testing, which is why it is essential that people and healthcare professionals are aware of the symptoms of CVD. However, since women with CVD often have different symptoms than men, signs of CVD may be missed. For example, while men experiencing a heart attack typically describe chest pain or discomfort, women are more likely to have non-chest pain symptoms such as shortness of breath, weakness, fatigue and indigestion. This can lead to young women being hospitalised, misdiagnosed, and discharged from emergency departments more often than men, highlighting the importance of not discriminating against younger age groups.
As someone who has experienced the challenges and knowledge gaps in the healthcare system, I know firsthand how difficult it can be to navigate. I often received conflicting information from various medical practitioners, and I was uncertain about what information to take seriously and what to disregard, as well as when to seek medical attention and when not to.
Additionally, there were other things I wanted to know, such as whether it was possible to have a baby with a heart condition, and I did not feel comfortable having these discussions with the medical practitioners available to me. There simply wasn’t enough information available to me to make informed decisions about my health and it was difficult for friends, family and work colleagues to understand what I was going through.
Sadly, my experience is not unique. That’s why I founded hearts4heart, a national organisation supporting, educating and advocating for Australians living with heart disease.
It’s time to do more to address the issues of underdiagnosis and under-treatment of CVD in women and younger people. We need to increase awareness, research, and resources devoted to addressing this crisis. This means uniting key stakeholders including clinicians, industry, and politicians to bring a unified voice to the issue. Let’s work together to ensure that all Australians receive equitable care and achieve better health outcomes.