A new study from Copenhagen University found women are less likely to receive lifesaving treatment for cardiogenic shock than men.
The study was presented at ESC Acute CardioVascular Care 2022 and was conducted by Dr. Sarah Holle et al.
Cardiogenic shock is a life-threatening condition in which the heart suddenly fails to pump enough blood to supply the body’s organs with sufficient oxygen.
It is usually caused by a large heart attack. It is estimated that up to 10% of patients with heart attacks affecting a large area of the heart also develop cardiogenic shock.
Only half of patients who experience cardiogenic shock will survive.
In the study, the team examined differences in treatment and survival between women and men with a heart attack and cardiogenic shock.
A total of 1,716 heart attack patients with cardiogenic shock were enrolled in the study, of which 438 (26%) were women. The average age of women was 71 years compared with 66 years for men.
The team found women were much more likely than men to be initially admitted to a local hospital (41% women versus 30% men), while much more men presented with out-of-hospital cardiac arrest (25% women versus 48% men).
When shock occurred, women and men had comparable clinical parameters such as blood pressure, heart rate, plasma lactate (a marker of oxygen levels in the organs) and left ventricular ejection fraction (heart pump function).
Regarding treatments, much lower proportions of women received mechanical circulatory support (19% women versus 26% men), minimally invasive or surgical procedures to restore blood flow to blocked arteries (83% women versus 88% men), and mechanical ventilation (67% women versus 82% men).
Women were much less likely than men to survive in the short- and long-term. At 30 days after the heart event, just 38% of women were alive compared with 50% of men. At 8.5 years, 27% of women were alive compared with 39% of men.
The team says there is increasing evidence that women with acute heart problems are more likely than men to have non-specific symptoms such as shortness of breath, nausea, vomiting, coughing, fatigue, and pain in the back, jaw or neck.
This might be one reason why more women than men in our study were initially admitted to a local, rather than specialist, hospital.
Related: Heart attack symptoms every woman needs to know.
The study is in line with a previous one from the University of Bergen and published in Nature Medicine, which found that half of the women with heart failure may get the wrong treatment.
For the other half of women experiencing heart failure, the cause is generally related to having untreated high blood pressure levels over time, which leads to progressive stiffening of the heart. There is no effective treatment for this kind of heart failure yet.
Researchers say that men and women have different biologies and this results in different types of the same heart diseases. It is about time to recognize these differences.
Another important point concerning how to avoid heart disease is to ask about what the national health service is doing on this issue.
Heart disease remains among the most common cause of death and a reduced quality of life in women.
The researchers say that medically speaking, scientists still do not know what the best treatment for a heart- attack or -failure is in many women.
In the review, they have compared common risk factors for heart disease and how these affect men and women differently.
They focused on sex differences in the effect of obesity, high blood pressure, and diabetes.
According to the World Health Organization (WHO), 11 percent of women and 15 percent of men are obese (BMI over 30 kg/ m2) globally. In Norway one in five adults is obese.
From a life span perspective, obesity increases with age, and this trend is greater for women than men. Obesity increases the risk of having high blood pressure by a factor of three. This, in turn, increases the risk of heart disease.
Obesity also increases the risk of type 2 diabetes. A woman with diabetes has a much higher relative risk of heart complications and death than a man.
The team explains that many of the differences between women and men when it comes to heart disease are connected to the sex hormone, estrogen.
The hormone prevents the formation of connective tissue in the heart, which makes it harder for the heart to pump. But in men, the effects are the opposite.
Obese men store estrogen in their fat cells in the abdomen, which has a bad effect on the heart.
After menopause, women lose the estrogen advantage. Their arteries become stiffer and more vulnerable to disease.
In the fact that for persons under 60, high blood pressure is most common amongst men. For persons over 60, it is the opposite.
The researchers think that this is part of the explanation for why high blood pressure seems to indicate a higher risk of heart disease amongst women.
They say smoking is also a part of the risk scenario for women. During the past decades, more women have started smoking than men.
For women, the effects of risk factors such as smoking, obesity and high blood pressure increase after menopause.
Increased recognition that women may have symptoms other than chest pain could minimize delays in diagnosis and treatment and potentially improve prognosis.
If you care about heart health, please read studies about small surgery that can prevent strokes in people with heart issues, and more than a decade of intermittent symptoms, then heart failure.
For more information about heart health, please see recent studies about …… and results showing this inexpensive heart drug can help treat severe COVID-19.
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