Women's heart disease risk rises with COVID

·3 min read

The pandemic may have put millions of more women — particularly young women — unknowingly on track for heart disease complications.

Driving the news: Several studies have emerged in the past year sounding alarms on how pandemic stressors like the increasingly difficult work-life balance, caregiving burdens and social isolation have left women bearing the brunt of this epidemic.

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  • "As time goes on, we are going to see the impact of the stress and lack of self-care that women have had to endure, which will predictably lead to the number one killer of all women, heart disease," warned one study from Mount Sinai in May.

By the numbers: Even before COVID, heart disease was already at the top of the list for women across all races and ethnicities, according to preliminary data from the CDC.

  • About 20% of both men and women have heart disease in the U.S., but many women of color and young women are at a higher risk.

  • Between 2015 and 2018, there were about 4 million women stroke survivors compared to 3.5 million men. About 3 million women had heart attacks within the same time period.

Now, the stresses on women have only gotten worse during the pandemic — and a study by two researchers at the Louisiana State University Health Sciences Center notes that there's a "clear link between psychological stress and heart disease."

  • The heightened pandemic stress is being caused by everything from job insecurity to the social pressure to care for children and older family members — and even gender-based violence as everyone has been stuck at home.

  • "[I]t is expected that with the given unprecedented levels of stress associated with the COVID-19 pandemic, women's [cardiovascular] health will be significantly compromised," the study warns.

Cardiologists are already seeing it in their offices.

  • "Women were suffering from great levels of stress before 2020, and I just feel like so many of my patients gained so much weight during the pandemic, alcohol intake went up, exercise went down, stress levels were higher," Malissa Wood, a cardiologist for Massachusetts General Hospital's women's heart health unit, tells Axios.

The big picture: Before the pandemic, women disproportionately died from heart disease when their symptoms and concerns about their cardiovascular health were ignored or even misdiagnosed.

  • Within five years of a heart attack, nearly 50% of women will die compared to 36% of men, according to the American Heart Association.

  • Women younger than 55 who arrived at emergency departments with chest pain waited 10 minutes longer to be seen, were less likely to be seen by a specialist, and were less likely to be admitted to a hospital or kept for observation compared to men, an NYU Langone study found in May.

What's next: Despite biological research milestones on women's heart health, researchers and doctors see a growing need post-pandemic to specialize in cardiology for women, enroll more women in clinical trials and change the culture in treatment options.

  • About 50% of women who come into the emergency room with symptoms concerning a heart problem don't have blockages in their main arteries and are usually sent home, a major flaw in cardiology, Samit Shah, an interventional cardiologist and assistant professor at the Yale School of Medicine, tells Axios.

  • This is because hospitals and emergency departments fail to look at a patient's smaller blood vessels where microvascular disease could be causing symptoms.

  • "All of the testing we do as cardiologists is based on looking for blockages. They’re not really tailored to women," he says.

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