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 Dr. Zheng.

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