“It’s disturbing that many women still don’t know the symptoms,” says the study’s senior author, Elsa-Grace Giardina, MD, professor of medicine and director of the Center for Women’s Healthat Columbia University Medical Center.
Campaigns to raise women’s awareness of heart disease—the leading killer of women in the US—have improved knowledge over the past 15 years. But 400,000 women in the US still die each year from heart attacks. “If more of these women were aware of the symptoms, we think more of them would take action, call 911, and survive,” she says.
In the study, Giardina and her colleague Laura Flink, MD, an internist at Columbia, asked 823 women who had never been diagnosed with heart disease to identify symptoms of a heart attack from a list of possibilities. (The study excluded heart attack survivors because they are presumably more aware of symptoms.)
Only 41 percent of high-risk women correctly identified the symptoms, compared with 61 percent of moderate-risk women and 75 percent of low-risk women. Risk was measured with the Framingham Risk Score and the components of metabolic syndrome (a group of risk factors that includes high blood pressure, insulin resistance, and extra weight around the waist).
Giardina thinks part of the problem is that these high-risk women don’t understand how high cholesterol, high blood pressure, and diabetes are related to heart attacks. “I see this in my own patients. Women will say, ‘I have high cholesterol so I need to take medication to lower it,’ but they don’t understand that high cholesterol raises their odds of having a heart attack,” she says.
“It’s important that people who deliver primary care do not simply identify women at risk, but take the time to make sure those women understand their risk and can recognize the symptoms of a heart attack.”
The research was published ahead of print in the journal Clinical Cardiology and was supported by the US Department of Health and Human Services (1HHCWH05003-01-11); the Arlene and Joseph Taub Foundation; the Edwina and Charles Adler Foundation; and Columbia University’s Irving Institute for Clinical and Translational Research (NIH grant UL1-RR024156).
Laura Flink received the Young Investigator Award from the American College of Cardiology, New York Chapter, based on her contributions to the research.