One in four middle-aged adults in Pakistan is living with cardiovascular diseases which are the leading cause of death in the country. Even though men and women are equally susceptible to developing heart diseases, the risk of dying or becoming severely unwell due to heart disease is largely underestimated in women due to under-diagnosis and under-treatment, said speakers at the 2nd Annual Cardiovascular Conference Pulse 2021 held at Aga Khan University.
Contrary to the belief that heart diseases affect only men, women are equally at risk. But they face unique sex-specific risk factors related to the early onset of menstruation, menopause and pregnancy-related complications such as preeclampsia. Women with diabetes are also more likely to die from cardiovascular diseases than men with diabetes.
“Gender matters in the manifestation of heart diseases,” said Dr Saira Bukhari, an assistant professor of cardiology in AKU Medical College's department of medicine. “Awareness of the differences in clinical presentation of heart diseases among men and women is key in tackling the burden of disease in the country.”
Women often report atypical cardiac symptoms, speakers noted. Clinical diagnosis of heart disease can be challenging as they may present with atypical manifestations of angina such as shortness of breath, weakness, fainting, nausea and non-coronary chest pain syndrome. Speakers added that women don’t always recognise their symptoms as those of heart disease or generally delay seeking medical help due to cultural barriers that restrict women’s access to healthcare facilities. They tend to present late in hospitals, thereby increasing their chances of subsequent heart failure and mortality.
“In addition to late presentation, treatment in women is less aggressive which results in poorer outcomes,” said Professor Zainab Samad, chair of AKU’s department of medicine. “Men and women may also have different preferences for their clinical care, and this has implications all the way from how facilities are set up to who offers clinical care. This is why it is important to have a gendered lens on diagnosis and management of cardiovascular disease across the continuum of care.”
Speakers at the event noted that there is also a shortage of trained female cardiologists. There are just 60 female cardiologists in a country where almost 30 percent of all deaths occur due to cardiovascular diseases. Lack of awareness of heart diseases in women at various levels of the healthcare system along with a shortage of women specialists is a detriment to patients seeking timely care, experts said.
The conference was held in collaboration between AKU Medical College’s section of cardiology and department of medicine and was endorsed by the Pakistan Cardiac Society, Scientific Council of Women Heart Diseases of the Pakistan Cardiac Society and Pakistan Hypertension League.
Keynote speakers who spoke at the conference included Dr Khalida Soomro, chairperson of the Scientific Council of Women with Heart Diseases in PCS, Dr Javed Butler, professor and chair of medicine at University of Mississippi, Dr Alexandra Lansky, professor and director of cardiology medicine at Yale University, and Dr Jamil Tajik, director of Cardiac Specialty Center, St. Luke’s Medical Center.
The event was attended by cardiologists, postgraduate trainees, nurses and other healthcare professionals.
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