Sudden Cardiac Death Gender Gap Closing in on Women
By Sophia Cariati
(Washington DC, 12/19/02): Women heart attack survivors are becoming almost
as likely as men to succumb to sudden cardiac death (SCD) later on, according
to results of a recent study adding to a growing body of evidence suggesting
that the gender gap is narrowing. The study results "...provide disconcerting
data that women may be unfortunately achieving equality with men in SCD incidence...,"
wrote William J. Groh, MD a cardiologist at Indiana University School of Medicine
in an editorial accompanying the research.
Sudden cardiac death (SCD), which takes the lives of more than 400,000 Americans
annually, is an abrupt and unanticipated death due to heart problems usually
occurring in an emergency room or before reaching a hospital. Studies, including
the long-term landmark Framingham heart study, completed in the early 1980s
and 1990s found that men with a history of heart disease were two to four times
more likely to die later of SCD compared with their female counterparts. The
newest findings, however, back up other evidence suggesting the risk for women
may be rising.
Steen Abildstrom, MD and colleagues at the National Institute of Public Health
in Copenhagen, Denmark conducted a prospective cohort study of close to 6,000
heart attack survivors for up to four years. Men enrolled in the study were
1.3 times more apt to die suddenly from heart-related causes compared with women.
The findings were published in the December 2002 issue of the journal Heart.
"An increasing amount of data suggests that women and their doctors need
to recognize that heart disease and sudden cardiac death are not just a man's
issue nor one of old age," said Zhi-Jie Zheng, MD, PhD, an epidemiologist
at the National Center for Chronic Disease Prevention and Health Promotion,
a branch of the Centers for Disease Control. In a recent study, Dr. Zheng and
colleagues revealed that the number of unexpected deaths caused by heart disease
jumped by more than 31% among young American women between 1989 and 1996. In
contrast, the rate among men increased by approximately 10 percent during the
same time period.
What is causing the higher rate of increase in the incidence of SCD in women
compared to men? Experts suspect that a number of factors are to blame. A significant
increase in the frequency of diabetes, overweight and obesity among women, an
upward trend in cigarette smoking, and less vigilant screening and treatment
of heart disease in women compared with men may all play a role, according to
Furthermore, data suggests that women may be less apt to recognize the signs
of a heart attack and thus delay seeking help. This holdup in treatment may
in turn boost a woman's risk of SCD. In a recent analysis of the state-specific
incidence of SCD in the United States, Zheng and colleagues found that women
had a higher proportion of out-of-hospital cardiac deaths than men. Close to
52 percent of women who succumbed to SCD died outside of the hospital compared
with approximately 42 percent of men.
Studies suggest that women may not be receiving timely care because they, along
with their physicians, are slow to spot the signs of heart disease. Since the
symptoms of heart disease in women are often quite different than those in men,
they may go unrecognized. Studies show that women are more apt to experience
jaw or neck and shoulder pain, nausea, vomiting, fatigue, or indigestion as
a symptom of heart disease than are men. Men, on the other hand, are more likely
to experience a "Hollywood heart attack" consisting of radiating right
arm pain and chest pain.
The Society for Women's
Health Research is the nation's only not-for-profit organization
whose sole mission is to improve the health of women through research. Founded
in 1990, the Society brought to national attention the need for the appropriate
inclusion of women in major medical research studies and the resulting need
for more information about conditions affecting women. The Society advocates
increased funding for research on women's health, encourages the study of sex
differences that may affect the prevention, diagnosis and treatment of disease,
and promotes the inclusion of women in medical research studies. Dr. Donnica
Moore has been a member of the Society since 1990 and is a past member of its
Board of Directors.
For more information about women and heart disease, click here.
Created: 12/21/2002  - Sophia Cariati