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Did you know that more women die from heart disease than men in our country? It’s true. but when it comes to researching treatments for heart disease, women are being left behind. So I wasn’t surprised when I read a recent article that highlighted the continued disparities of heart disease treatment between men and women.

From an ABC News article — Heart Device Studies Leave Women Behind:

Cardiovascular device development remains skewed against women, with too few trials adequately addressing gender despite long-standing requirements by the FDA, researchers found.

I contacted Carolyn Thomas of Heart Sisters to ask her if I could get her thoughts on this latest report for BlogHer, and she was kind enough to agree. Carolyn writes about women and heart disease from a very unique perspective: she is a Mayo Clinic-trained heart attack survivor. what she has to say about women and heart disease, we ALL need to hear.

My first question was…

With heart disease being the leading cause of death among women — did this report surprise you?

Carolyn’s response:

Sadly, this report does not surprise me — but it does discourage me. the prevailing attitude seems to be that if health care treatments work for men, shouldn’t they also work for women? the Society for Women’s Health Research has some interesting answers to this question. I wrote an article in 2009 called “Cardiac Research: Where did All the Women go?: on my blog Heart Sisters, including a link to SWHR’s compelling statistics.

How important do you think it is for women to be included at an equal rate to men in these studies?

Carolyn’s response…

Of course it’s important! In almost every area of our health, there are significant differences between men and women’s responses to both disease and treatment. but because women are not yet equally represented in many areas of medical research — not just cardiology research — our health care professionals have had to assume that diseases and conditions affect both women and men in the same way.

And women’s medical research until very recently has generally focused on what we call the ‘bikini approach‘ to our health: breasts and reproductive organs.

How concerned should women with heart disease be about this latest report?

Carolyn’s response…

Any report that indicates “incomplete safety and efficacy details for women” is discouraging and alarming for us, and it comes back to that gender gap in research trials. we know that women do volunteer for hormone or breast cancer clinical trials — but don’t seem as interested in participating in cardiac research. This is likely because many women still mistakenly believe that heart disease is a man’s problem, even though it is the #1 killer of women, and indeed kills more women every year than men.

But women are not alone in our ignorance. In a 2005 American Heart Association study, physicians were asked if they were aware of the fact that cardiovascular disease kills more women than men each year. the results were absolutely shocking: Only 8% of family physicians knew this fact, but (even more frightening!) only 17% of cardiologists were aware of it.

Are there other areas of heart disease treatment where there is a clear lack in the research of women?

Carolyn’s response…

Personally, I’m particularly interested in our current cardiac diagnostic tools – mostly because, like many women, I was sent home from the E.R. in mid-heart attack with a misdiagnosis of acid reflux, despite presenting with textbook heart attack symptoms like crushing chest pain, nausea, sweating and pain radiating down my left arm. yet all my cardiac diagnostic tests that day were “normal” — EKG, blood tests, and a treadmill stress test.

Without accurate gender-specific diagnostic tests, how can our physicians even begin to decide on appropriate life-saving treatment, drugs or devices for us? Until these cardiac tests are researched and developed, however, women heart patients will continue to be sent home from the E.R. misdiagnosed with everything from indigestion to anxiety or menopause (a very handy all-purpose diagnosis!)

The stats on gender differences in diagnostic testing are alarming. Research reported in the New England Journal of Medicine, for example, looked at more than 10,000 patients (48% women) who went to their hospital Emergency Departments with chest pain or other heart attack symptoms. Investigators found that women younger than 55 were seven times more likely to be misdiagnosed than men of the same age. the consequences of this were enormous: being sent away from the hospital doubled the chances of dying.

Shortly after my own heart attack in 2008, I attended the WomenHeart Science & Leadership Symposium for Women with Heart Disease at Mayo Clinic, where I was shocked to learn that many diagnostic tools widely considered to be accurate in identifying heart disease in men are far less accurate in women — particularly in women with these specific types of cardiac events that are far more commonly seen in ‘us’ than in ‘them’:

1. single vessel coronary artery disease

2. non-obstructive coronary artery disease (like coronary microvascular disease or Prinzmetal’s Variant Angina, a coronary artery spasm condition)

3. SCAD — spontaneous coronary artery dissection (up to 80% of SCAD cases occur in young healthy women with no cardiac risk factors)

Here are some other areas of heart disease treatment in which the research gender gap is evident. when Dr. Wendy Tsang reviewed landmark cardiac clinical trials published over a 10-year period in three prestigious medical journals — the Journal of the American Medical Association, the Lancet, and the New England Journal of Medicine — she found that although women comprise 53% of patients with cardiovascular disease, in clinical trials they represented only 34% with cardiac arrhythmias, 29% of subjects with coronary artery disease, and 25% with congestive heart failure. That’s just not good enough.

My last question…

Do you think it is going to take a government mandate to close this gender gap?

Carolyn’s response…

Back in the early 1990s, the National Institutes of Health implemented sweeping policy changes in research protocol to ensure fair representation of women in cardiac research trials. So you may well ask: “What the heck happened?”

But despite the government’s best intentions, there may well be some truly sticky obstacles to achieving gender balance in these trials. Under-representation of women in cardiac research could be partly because they are asked to participate less often than males. Women don’t volunteer to participate even when asked because they may believe that heart disease is really just a man’s problem. Women also tend to develop heart disease later in life than men do; some trials have age restrictions that limit the enrollment of research participants over the age of 70. however, Dr. Wendy Tsang’s research does show women do make up over 60 per cent of heart disease prevention trials that investigate exercise and diet. Could this be due to gender stereotyping?

Thank you Carolyn, I think every woman who reads this will learn something she didn’t know about heart disease and why closing the gender gap in research is so important. 

Has heart disease touched you or your family?  Are you concerned about the lack of women in heart disease studies?  I hope you will let us know your thoughts in comments.

Contributing Editor Catherine Morgan Also at Catherine-Morgan.com

It’s not a pleasant subject, but the community must come to grips with African-Americans’ shockingly high incidence of sexually transmitted diseases, a health official says.

“When it comes to sexually transmitted disease, people tend to shy away from the subject because it involves talking about sex,” Dr. David Holcombe, regional administrator and medical director for Region VI of the state Office of Public Health, said Tuesday at a forum in Alexandria on STDs.

“The only way to let people know of the dangers of STDs is to get the message out about them. There’s no shame in talking about ways to prevent sexually transmitted diseases,” Holcombe said.

Not only does Louisiana lead the nation in the rate of syphilis and rank high in the incidence of other STDs, but African-Americans have much higher rates than their white counterparts, officials said.

Health officials and community leaders gathered Tuesday in the Alexandria Museum of Art for the forum titled “Closing the Gap: Addressing STD Disparities in the African-American Community.” They sought to spread the message on the dangers of STDs, particularly in the black community.

The forum was a collaboration with Central Louisiana AIDS Support Services and the Office of Public Health.

In addition to being first in syphilis incidence, Louisiana is No. 2 in the nation in gonorrhea, No. 3 in chlamydia and No. 4 in HIV, officials said.

A PowerPoint presentation was given on the number of STD cases.

Sexually transmitted diseases affect 15 million people each year in the United States and cost

$8.4 billion in medical costs and lost wages. By age 25, one-third of all sexually active young adults will have been infected by one or more STDs, Holcombe said.

Kevin Bonton, an Office of Public Health disease intervention specialist, talked about the number of gonorrhea, chlamydia and syphilis cases in Rapides Parish, citing statistics from the Louisiana Office of Public Health 2009 STD annual report.

Females and males ages 15 to 29 carry the burden of STD infections, and gonorrhea rates are 20 times higher in blacks than in other minorities, Bonton said.

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He said individuals should discuss their sexual histories with their partners before engaging in any sexual act.

“We see a lot of African-American women getting tested for STDs but not African-American men,” Bonton said.

“So many African-American men have multiple sex partners. We recommend getting tested when a person has multiple sex partners.”

Chaquetta Johnson, Office of Public Health regional nurse consultant, showed how a female infected with an STD could pass the symptoms to her unborn child.

Johnson also talked about Pelvic Inflammatory Disease and cervical cancer.

“Eighty percent of sexually active women will be tested positive for HPV (which can lead to genital warts) in their lifetime. Congenital syphilis is on the rise 23 percent between 2005 to 2008,” Johnson said.

“I think factors like living conditions and education can play an important role in STDs. you have to educate people on STDs, and that comes from community organizations getting involved to eliminate the problem.”

Sandra Bright, nurse educator at the Huey P. Long Medical Center facility at England Airpark, said African-Americans represent 14 percent of the U.S. population, but half of HIV victims are African-Americans.

As of Dec. 31, 2009, 30,876 individuals were diagnosed with HIV-AIDS in Louisiana, Bright said.

She said 78 percent of the HIV victims in Louisiana are black.

“This is due to factors like access to care, social, economic and cultural factors. the African-American community must educate in places like home and church. Sororities and fraternities can also help educate on diseases that are killing the black population,” Bright said.

One of the nation’s most common forms of sexually transmitted diseases has fallen to its lowest level ever recorded, but there’s still improvement needed, according to a new government report out Monday.

The report, part of the Centers for Disease Control and Prevention’s annual report card on sexually transmitted diseases (STDs), found that gonorrhea rates in 2009 – the most recent year for which figures are available – were at their lowest level since 1941. The report also found that syphilis rates among women held steady after several years of increases. But the nation’s chlamydia cases were up 19 percent.

The CDC said that while overall the findings are encouraging, “there are large disparities in STD rates by race and age. Some racial/ethnic minority groups have much higher STD rates than whites, and young African Americans are particularly hard-hit.”

Syphilis rates among young black men were about double the rate they were in 2005, the CDC found. Chlamydia rates reached a record high in 2009, which the CDC said probably represents increased testing for the disease.

Gonorrhea infections in 2009 dropped to about 111 cases per 100,000 population, down 10.5 percent from 2008, The 2009 rate, the third consecutive annual decline, was the lowest since record-keeping began in 1941.

A single test can screen for gonorrhea and chlamydia. in 2000, a quarter of women 25 and under were tested for chlamydia, compared with nearly half in 2009.

Once diagnosed, all three reportable STDs are easily treated with antibiotics, said Charlotte Kent, acting director of the CDC’s Division of STD Prevention. although gonorrhea causes symptoms, chlamydia is likely not to, so testing is critical, she said.

“Undiagnosed chlamydia and gonorrhea are preventable causes of infertility,” Kent said.

The overall syphilis rate has risen every year since 2001, mostly in men but, more recently, in women. in 2009, there were 4.6 cases per 100,000 population, a 59 percent jump since 2005.

Jeanne Marrazzo, president of the American Sexually Transmitted Disease Association, called the syphilis rate “alarming.”

Rates of all three STDs are higher in blacks than whites, Kent noted. “We’ve seen some definite signs of progress, but we still see these disparities exist,” she said.

The 2009 syphilis rate in blacks was nine times that of whites; in 1999, the difference was 24-fold.

“It’s not an issue of behavior,” Kent said, but one related to the fact that the three STDs are more common in blacks.