Although nearly three-quarters of women taking a recent survey had one or more risk factors for heart disease, a startlingly small proportion--just 16 percent--had actually been told by their doctors that these factors put them at risk for heart disease, according to a study scheduled for presentation at the American College of Cardiology's 65th Annual Scientific Session.
Medical guidelines recommend anyone with a heart disease risk factor should receive regular blood pressure and blood cholesterol checks, as well as counseling on smoking and heart-healthy lifestyle changes. The survey revealed many women were not given proper follow-up care and that many were simply told to lose weight.
In addition, nearly half of the survey participants admitted to canceling or postponing a health appointment until they could lose weight, suggesting a focus on weight management could present a significant barrier to receiving proper health care.
"Women's heart awareness has stalled, despite almost three decades of campaigning by numerous women's heart health advocacy groups," said C. Noel Bairey Merz, M.D., FACC, medical director of the Barbra Streisand Women's Heart Center at Cedars-Sinai Heart Institute and the study's lead author. "We wanted to understand what the roadblocks were and why women and their physicians were not taking action to monitor their heart health."
More than 1,000 women participated in the Internet-based survey, administered by GfK KnowledgePanel as part of a study organized by the Women's Health Alliance. To recruit a sample representative of 97 percent of American households, organizers provided Internet access for participants who did not otherwise have access. The survey asked women about their health conditions and their experiences interacting with health care providers.
The results revealed 74 percent of women had at least one heart disease risk factor, such as high blood pressure, high blood cholesterol, diabetes, irregular menstrual periods, early menopause or a family history of heart disease. Only 16 percent of women reported being told by a doctor that they have or are at risk for heart disease, while 34 percent reported being told to lose weight.
"Women feel stigmatized. They are most often told to lose weight rather than have their blood pressure and blood cholesterol checked," Bairey Merz said. "If women don't think they're going to get heart disease and they're being told by society and their doctors that everything would be fine if they just lost weight, that explains the paradox of why women aren't going in for the recommended heart checks. Who wants to be told to lose weight?"
Younger women, non-Caucasian women and women with lower socioeconomic status were found to be least likely to be aware of heart disease risk factors and key symptoms and least likely to be aware that heart disease is the leading cause of death in men and women in the United States.
Although obesity is considered a risk factor for heart disease, the study results suggest that focusing directly or exclusively on weight loss can be counterproductive by discouraging women from keeping health appointments, further reducing the chances that they will receive appropriate monitoring and counseling.
"We need to work very hard to get physicians and the health system to adopt prevention guidelines in their everyday practice," Bairey Merz said. "Preventing heart disease is not about weight. It's about getting your blood pressure and cholesterol checked. For some people, it's about getting your sugar checked, being told not to smoke, being heart healthy and exercising. That's how we prevent heart disease."
The findings dovetail with a 2015 survey by the same research group, which asked cardiologists and primary care physicians about how they advise female patients with heart disease risk factors.
"Our physicians' survey corroborated what we heard from women--they seem to prioritize weight loss over pretty much everything else," Bairey Merz said.
Three-quarters of women said they rarely or never discuss heart health with family or friends, a factor Bairey Merz said is likely tied in with social stigmas around body weight. The findings suggest a need to counter stereotypes about body weight and heart disease with more evidence-based communication and preventive care, she said.
Although the new survey did not include men, previous studies have shown that men are significantly more likely to receive recommended heart health monitoring and less likely to be told to lose weight as compared to women.
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