Heart Disease Gender Gap Narrows

Hearts attacks have increased among middle-aged American women in the past two decades, but their chance of survival has improved, two new studies show.

"We found that men still have a higher prevalence than women, but what has happened is that the gap has narrowed," says Amytis Towfighi, MD, an assistant professor of clinical neurology at the University of Southern California and lead author of one of two reports in the Archives of Internal Medicine. "For women it has increased, for men it has decreased."

Her study used data from two national surveys conducted from 1988 to 1994 and 1999 to 2004. While 2.5% of the men and 0.7% of the women reported a history of heart attacks in the earlier survey, 2.2% of men and 1% of women reported heart attacks in the more recent survey.

The narrowing of the male-female difference is easily explained, Towfighi states. "Very basically, the risk factors are being better controlled in men than in women."

In men, levels of LDL cholesterol remained the same between the two surveys, while levels of HDL cholesterol improved. Blood pressure levels improved, and fewer men smoked. The improvements for women were marginal, with LDL cholesterol levels about the same. The only risk factor that improved in women was HDL cholesterol. Diabetes and obesity increased in men and women, the study found.

"We don't know exactly what is going on in terms of risk factors being better controlled. Women aren't checked as often," Towfighi acknowledged.

The second study used information from a different data bank listing death rate trends from 1994 to 2006. It found a marked reduction in hospital deaths from heart attacks in all patients, especially among women. For women under the age of 55, the risk of dying dropped by 53% , which was the greatest improvement noted. The least reduction, 33%, was seen in men under the age of 55.

A detailed examination of cardiac risk factors showed that "women experienced less worsening than men," says Viola Vaccarino, MD, PhD, a professor of medicine and director of the Emory Program in Cardiovascular Outcomes Research and Epidemiology and the report's lead author.

But changing attitudes about women and heart disease may also have had an effect, she says.

"Perhaps physicians are paying more attention to the detection and treatment of women with heart disease," Vaccarino says. "It could be the same thing happening in the general public, with women getting more knowledgeable about this."

— Source: Brigham and Women's Hospital