Women often face barriers to the diagnosis and treatment of heart conditions. A new scientific statement from the American Heart Association examines additional risk factors and barriers faced by women of underrepresented races and ethnicities.
Heart disease is the leading cause of death among both men and women, yet traditional risk formulas used by health professionals often miss women who are at high cardiovascular risk. This is often due to sex-specific differences that influence risk, including pregnancy-related conditions, menstrual cycle history, birth control use, polycystic ovary syndrome, autoimmune disorders (women have a much higher prevalence of autoimmune disorders than men), and depression/post-traumatic stress disorder (again, these disorders are much more common in women).
While all women are negatively impacted by cardiovascular risk formulas that tend to be centered around men, women of underrepresented races and ethnicities disproportionally face additional barriers related to social determinants of health. For example, social factors that impact cardiovascular risk can include economic stability, neighborhood safety, work and working conditions, environmental pollution and hazards, education levels, and healthcare access, all of which disproportionally affect underrepresented groups. Additional issues such as language barriers, acculturation, and discrimination can also affect underrepresented races and ethnicities.
Further complicating risk assessment, cardiovascular risk profiles vary significantly based on race and ethnicity. For example, non-Hispanic Black women in the US have the highest rates of high blood pressure in the world and are more likely than other women to develop type 2 diabetes and obesity. Hispanic/Latina women tend to have higher rates of obesity than Hispanic/Latino men, and those born in the US have higher rates of smoking than those who immigrated to the US. An author of the statement noted that treatment and prevention strategies for cardiovascular disease in women need to be customized to include a variety of interconnected factors, including sex, race, ethnicity, and social determinants of health.
Sources: AHA, Science Daily