Rates of the Disease Are Rising Among Younger Women

Mahdi Garelnabi in research lab
Assoc. Prof. Mahdi Garelnabi published an analysis that demonstrates that women are treated and diagnosed for heart disease differently than men.

By Karen Angelo

A new analysis of 15 global studies on cardiovascular disease shows that women are diagnosed and treated later than men for cardiac issues, resulting in worse outcomes for women than for men. 

Biomedical and Nutritional Sciences Assoc. Prof. Mahdi Garelnabi and his colleagues reviewed studies conducted in more than 50 countries, which included more than 2.3 million people. The analysis represents a wide range of regions, including the Arabian Gulf, Brazil, China, Egypt, India, the U.S. and others. 

“We found stunning differences between men and women in the diagnosing of cardiovascular disease, treatment and symptoms,” says Garelnabi, who chairs the Diversity, Equity and Inclusion Committee of the North American Vascular Biology Organization. “Women tend to go to the hospital later than men after the onset of symptoms. And physicians are not admitting women to the hospital at the same rates as men.” 

In the U.S., the Centers for Disease Control and Prevention reports that more than 60 million women are living with some form of cardiac disease, the No. 1 killer in the world of both men and women. 

Published in the August 2023 issue of the peer-reviewed journal “Arteriosclerosis, Thrombosis, and Vascular Biology,” the analysis concluded that when women experience heart issues, they may suffer more than chest pain. Symptoms such as vomiting, jaw pain and abdominal pain are also common. If these symptoms are missed by doctors or by the patients themselves, diagnosis and treatments are delayed. 

Heart Disease Increasing in Younger Women Compared to Men 

The analysis also points out that heart attack rates among younger women are climbing. Among women ages 35 to 54, heart attacks increased from 21% to 31% between 1995 and 2014. During the same time frame, the rate for men moved up slightly, from 30% to 33%. 

In another study of nearly 15,000 patients with coronary artery disease, among younger patients, women were associated with a six-fold increased risk of dying within 30 days. 

“It’s alarming that heart attack rates are increasing in younger women,” says Garelnabi. “Risk factors that are unique to women include premature menopause, endometriosis and hypertension disorders during pregnancy.”

Gender Differences 

The analysis showed another difference between genders when a blood test, a high-sensitivity troponin assay biomarker, is used by doctors to detect heart damage. The results of the biomarker may not be elevated for women the same way it is for men, giving doctors misguided information. 

“There’s nothing wrong with the biomarker,” says Garelnabi, who directs UMass Lowell’s ADVANCE Office for Faculty Equity & Resilience and the Core Lab for the Center for Population Health. “There’s something wrong with the way the guidelines are explained per gender for interpreting the biomarker. It’s possible that a woman’s hormones are interfering with the results of the test.” 

It’s not just the patient’s gender that plays a role in cardiac outcomes, according to the analysis. The gender of the doctor also makes a difference. In one of the studies of patients treated in Florida hospitals, the results showed that when women were treated by women doctors, their probability of death rate was reduced from 11.9% to 5.4% relative to the entire study population. 

“The data show that the differences by gender for symptoms, hospital admittance, diagnoses and treatments have resulted in women experiencing worse outcomes than men for cardiovascular disease,” says Garelnabi. “This is a preventable disease that can be improved through clinical research and awareness among the medical community and individuals. We know that the sooner someone is treated, the greater their chances of recovery and survival.”