Expert Blogs | Heart Health
Do Women Cardiologists Treat Women's Hearts Better?

Women cardiologists know the way to their female patients’ hearts.

When it comes to keeping your heart healthy long-term, a new study shows that women with heart health issues get better treatment if they’re seen by a female cardiologist.

According to a systematic review from the American College of Cardiology’s Cardiovascular Disease in Women section published in the Journal of the American College of Cardiology, female physicians have better patient outcomes, compared with their male peers, while female patients are less likely to receive guideline-recommended care when treated by a male physician.

There are a number of reasons care differs when it comes to gender. Heart disease presents itself differently in women vs. men, and there’s a lack of women’s health training in U.S. medical schools. There’s also an underrepresentation of female subjects in clinical trials. Currently, of all the cardiology students in the U.S., only 18% are female.

Another thing that helps female cardiologists provide better care to our female patients is that we understand female patients better than men do. I can draw from my own experience and pick up on subtle signs a male doctor might not catch. Our communication tactics are slightly different, and understanding the nuances make all the difference.Our communication tactics are slightly different, and understanding the nuances make all the difference.

Timing Is Everything

It’s still all too common that cardiac care for women gets unnecessarily delayed due to misdiagnosis or ignorance of the esoteric nature of symptoms in women. And that means more heart muscle damage. More subsequent risk of death. Time is muscle.

I’m involved with the Go Red for Women movement, an initiative created by the American Heart Association that has been educating and empowering women to take care of their hearts and their heart health for almost 20 years. Yet, after all this time, I still become infuriated every time I see the statistics that women are still under-diagnosed, still provided with less life-saving treatment, and still referred less often for procedures that might actually result in more successful outcomes for them.

Heart Disease Is the No. 1 Killer of Women -- But It’s Preventable

The good news: Research is finally catching up to reality. In the last decade, we have made significant progress in the study of women and heart disease.

The Guidelines for the Prevention of Cardiovascular Disease in Women, last updated in 2011 by the American Heart Association, showed the profound impact of hypertension, diabetes, and depression on women’s hearts and explained that pregnancy can be a sort of “metabolic stress test” because there are many warning signs of future heart disease in pregnant women.

There are also the Guidelines for the Prevention of Stroke in Women, issued jointly by the American Heart Association and the American Stroke Association in 2014, showing that pregnancy, hormones, and migraines all contribute to the risk of stroke.

Furthermore, the American Heart Association’s Scientific Statement from 2016 about Acute Myocardial Infarction in Women sheds light on how women who have had a heart attack are less frequently referred to life-saving treatment and are less likely to be prescribed medication to prevent complications, improve quality of life, and to prevent a second heart attack. (Note that “myocardial infarction” is the medical term for heart attack.)

This is all progress, but there remains a desperate need to ensure quick diagnosis and proper long-term care for women with heart disease. Therefore, the study authors suggest making three main shifts to elevate the treatment of women by male doctors.

  • Increase gender diversity in the physician workforce.
  • Improve gender- and sex-specific medical training.
  • Increase research on the role of gender in patient-physician relationships.

This is all significant, but change isn’t happening fast enough. I believe that in order to alter these statistics, we have to change the culture, which, as we all know, is a slow process. We’re still seeing more women dying of heart disease, and heart disease in women still causes more deaths than all cancers combined.

Therefore, I propose that we focus on the preventive aspects of heart health and provide active and effective strategies for early detection of disease in every at-risk woman before there are clinical manifestations. And by every at-risk woman, I mean every woman.

In the meantime, women (and I include myself, of course) need to take charge of their hearts and understand the critical nature of being their own advocates and fighting for the help they need to implement the preventive strategies that we already know.

Be Proactive About Your Health

As the treatment of women and heart disease continues to evolve, whether your current doctor is male or female, you must always advocate for your own health and yourself.

It’s critically important to ask questions. You won’t always have a doctor who’s good at this, but I suggest that you find one if you want the best care. A good doctor won’t expect your questions to be perfect or exactly on target or even obviously relevant to your condition. A good doctor will listen and get to the bottom of the “why.”

This takes some bravery, I know, but your doctor works for you and is there to help you. Questions are the perfect way to get the help you need and to foster a healthy doctor-patient relationship. And that’s one of the most important ways to achieve wellness.

Considering all of this, here are some guidelines for communicating with your doctor:

Know that you aren’t alone. Your doctor has probably heard your questions many times before. They’ll likely have good guidance for you, once you understand each other.

Take Preventive Measures

In addition to asking questions it’s important that you take steps to prevent heart disease as a whole.

Heart disease almost always results from a mix of` genetic causes and lifestyle factors. It all goes back to basics:

  • Get tests to understand your cholesterol level, blood pressure, and blood sugar. Get a coronary artery calcium score (a screening test for plaque in the arteries). Tell your doctor you want to establish a baseline so you can best monitor your own health.
  • Stop smoking.
  • Exercise regularly -- at least 3-5 days a week -- and get your heart rate up to a moderate intensity for at least 30 minutes!
  • Get to a healthy weight.
  • Manage your stress.
  • Eat a heart-healthy diet full of vegetables, fruits, whole grains, and healthy fats.
  • If you need medication to lower your risk factors, don’t dismiss this option! It could save your life.
  • If you think something is wrong, seek medical attention immediately. Don’t make excuses.
  • Take your health seriously. Be proactive. Let your voice be heard and advocate for yourself.
  • Don’t put yourself on the bottom of the list. Make your health a priority.

As women’s needs are increasingly coming to the forefront of the cultural mindset, let’s take advantage of this momentum to use the tools we have to become less reactive and more proactive in caring for our hearts in ways that are effective. It’s time to set aside opinions, old ways, and traditional methods in favor of the current data, because so far, our opinions have been selling women short.

 

 

Photo Credit: Jose Luis Pelaez Inc / DigitalVision via Getty Images

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Suzanne Steinbaum, DO

Suzanne Steinbaum, DO

Board-certified cardiologist

Dr. Suzanne Steinbaum is a leader in preventive cardiology, now in private practice in New York. She launched heart prevention programs at Mt. Sinai Heart, Northwell Lenox Hill and Beth Israel. She is the CEO/Founder of Heart Tech Health, a technology-based prevention model. She published Dr. Suzanne Steinbaum’s Heart Book: Every Woman’s Guide to a Heart Healthy Life and has been an advocate for women's health for two decades appearing on The Doctors, Oz, The Today Show and Good Morning America. She now is an advisor and spokesperson for American Heart Association, Go Red For Women and Peloton.

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