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Abstract
Background Globally, cardiovascular disease (CVD) remains the leading cause of mortality in women. The incidence is rising in young women with more death in women compared to men, due to sex-related disparities in CVD awareness and management. However, women continue to underestimate their CVD risk and are uninformed of sex-specific symptoms. We attempted to assess whether this was the case in a tertiary centre cardiology outpatients department (OPD).
Methods 85 women attending a tertiary centre cardiology OPD responded to a multiple-choice questionnaire designed to address awareness of CVD as a cause of mortality, CVD risk factors and sex-specific symptomatology. Statistical analyses: SPSS version 29.0.2.0 (20).
Results Awareness of CVD mortality: 65% cited CVD as the leading cause of death in men but only 32% in women with 27% citing breast cancer. 93% of respondents felt somewhat concerned or very concerned about the likelihood of developing CVD in their lifetime however only 40% had discussed CVD risk with a healthcare professional. 52% had been CVD risk assessed.
Perceptions of CVD risk factors (RF) and behaviours: the top 3 factors were high blood pressure (27%), smoking (19%) and obesity (15%). Diabetes was not selected as primary RF, 34% considered it the least important RF.
Sex-specific symptomatology: Only 11% selected unexpected tiredness as being a sign of MI. Autonomic symptoms, were less likely to be chosen, with nausea or vomiting, sweating or light-headedness or feeling dizzy selected by 35%, 29% and 22% respectively.
Regression analysis: age was highly significant at predicting responses when assessing likelihood of discussing CVD risk, prior risk assessment and having taken steps to reduce risk.
Conclusions Almost a third of respondents selected breast cancer as the leading cause of death in women, despite twice as many women dying from CVD. Twice as many women selected CVD as the major cause of death in men – in keeping with the popular perception of CVD being a men’s disease and attributed to the historical absence of women participants in research.
Awareness of sex-specific symptoms associated with CVD was also poor and highlights the paucity of data relating to sex-specific mechanisms of CVD.
This lack of awareness culminates in increased morbidity and mortality in a largely preventable disease process. Historically, the fact that cardiovascular pathophysiology is different in women has been neglected - but it has led to ignorance among healthcare providers and the public alike, resulting in worse outcomes for women.
CVD awareness is only one facet in the effort to prevent unnecessary deaths in women. Other factors such as physician education and greater involvement of women in research must also be tackled. However this questionnaire should spark action in healthcare providers to enable patient empowerment with sex-specific education, and to catalyse changes in the way we practise medicine and ultimately save women’s lives.
Consolidated patient demographics
Conflict of Interest None