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June 29, 2017

The reason a surprising number of women skip doctors' visits—and what it means for their hearts

Daily Briefing

Heart disease is the leading cause of death for women, but many women, and providers, do not recognize the danger, which may delay potentially lifesaving preventive care, according to a survey published last week in the Journal of the American College of Cardiology.

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For the survey, researchers from Cedars Sinai Heart Institute questioned 1,011 women between the ages of 25 and 60, as well as 200 primary care providers and 100 cardiologists. The surveys, which were conducted in 2014, sought to identify barriers that women and physicians face in the diagnosis and treatment of cardiovascular disease.


The survey found that 45 percent of the women were unaware that heart disease is the number one killer of women, and only 40 percent said they had received a heart health assessment from their doctor.

The survey found that 74 percent of women had one or more risk factors for heart disease, but only 16 percent had been told so by a doctor. In addition, 26 percent of the women said that having heart disease would be embarrassing because they were afraid people would assume it had been caused by poor diet or insufficient exercise.

Doctors may not recognize the extent of women's cardiovascular risks, either. The provider survey found that only 39 percent said that heart disease would be their top health concern for their female patients. In addition, just 22 percent of primary care physicians and 42 percent of cardiologists said that they believed they were well-prepared to discuss heart disease with their female patients.

The surveys uncovered another reason why women may not be promptly diagnosed with heart-health risk factors: 63 percent of women said that they sometimes put off a medical visit because they want to lose weight first, while 45 percent said they've canceled or postponed medical visits for that reason. The researchers said this practice could delay potentially lifesaving care.


The researchers said more must be done to raise awareness and educate providers and patients about the risk of heart disease in women.

"Eighty percent of heart disease is preventable, yet women's heart disease is underdiagnosed, under-researched and underfunded," said British Robinson, the head of the Women's Heart Alliance, a not-for-profit organization that helped fund the study. She added, "It is critical that women ask their health care providers to check their hearts and that health care providers know that when it comes to heart disease, men and women are different—women's hearts are smaller, their risk factors are different, and their symptoms may be different."

Holly Andersen, director of education and outreach at New York Presbyterian's Ronald O. Perelman Heart Institute, said that the fact that women put off going to the doctor or discussing heart disease is a "very dangerous thing." She added, "Women all too often wait if they think there's a problem with their heart, and all too often they could die waiting, because sometimes the first symptom of heart disease is sudden death and that's why prevention is so important" (Villarreal, CBS News, 6/22; Edwards and Fox, NBC News, 6/22; HealthDay News/United Press International, 6/22).

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