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Heart disease in women is under-diagnosed, under-treated and under-researched: Heart and Stroke report

Patti LeBlanc had just finished preparing her vegetable dish for her church’s December potluck when she felt an odd sensation throughout her body while putting her stuff in her car.

At first, the marathon runner dismissed it as nothing and continued about getting ready for the potluck. But as she drove to the church, a feeling of pain in her chin and face manifested. Her chest also felt very heavy and LeBlanc couldn’t quite catch her breath, but she kept on driving.
Moments later after arriving at her church, the then 49-year-old’s arm began to tingle and it quickly became numb.
“That was when I first thought that I could be having a heart attack,” said LeBlanc, who was 49 at the time. “So I got in my car and phoned my husband right away and told him something was really wrong, and that I might be having a heart attack and told him to call an ambulance.”
LeBlanc rushed home to meet paramedics, who gave her two Aspirins and drove her to the hospital, where she was wheeled into surgery.
For three hours, doctors worked on two tears in her arteries, which is also known as a SCAD, or a spontaneous coronary artery dissection.
“It was a shock that I’d had a heart attack,” she says. “I’d done everything to not have a heart attack – I ate well, exercised and managed my stress. I remember being quite bitter about the predicament I was in.”
 It may have taken a buildup of symptoms for LeBlanc to realize she was having a heart attack, but many women and physicians fail to actually recognize the early symptoms of a heart attack in women at all. In fact, early heart attack signs were missed in 78 per cent of women, according to a new report by the Heart and Stroke Foundation.
“[Heart disease] is a major cause of death and I think people really still don’t understand that,” Dr. Karin Humphries, scientific director of the B.C. Centre for Improved Cardiovascular Health, says. “I think if you ask the average woman on the street what her biggest health concern is, it’s probably dying of breast cancer – which is not to minimize that that isn’t important. But women are actually five times more likely to die of cardiovascular disease. It’s a major killer of women.”
According to the report, when it comes to women and heart disease, they are under-researched, under-diagnosed and under-treated – not to mention under-supported and under-aware – and it’s chalking up to be a very dangerous combination for the future of women’s heart health.

Where’s the research?

The system’s failure in women’s heart health started with research where for years, therapies were tested in studies that primarily involved middle-aged, white men.
In reality, two-thirds of heart disease clinical research focuses only on men, despite women comprising 51 per cent of the population, the report notes.
Researchers believed that what they learned from these study groups could be applied to all, thus forming the basis of clinical guidelines, diagnostics and therapies that are still widely used for both sexes today.
“I think there was a real reluctance to enrol women because of concerns of adverse effects if they happen to be pregnant – you know, the complexity of women’s hormone change – I think that’s where it started,” Humphries says. “But when you start making assumptions of what works in men will work in women, you can really get into trouble. We have now learned that medications and treatments that are shown to work in men, some of those can actually have adverse effects in women.”
That’s because women’s hearts and the way they experience heart attacks are different than men, Humphries explains.

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