The stereotype of the overweight, unfit bloke as a heart attack in waiting masks a deadly fact. In fact, more young women suffer from cardiovascular problems than men, heart experts warn. Across the UK, there are 710,000 women, aged 16-44, living with heart disease compared to 570,000 men, according to British Heart Foundation (BHF) research.
Professor Peter Weissberg, BHF medical director, said clear signs of heart complaints are going unnoticed by women. “There’s a great tendency for women to ignore symptoms because they think of it as a man’s problem. Women are affected by heart disease and sometimes more than men.”
Doctors believe the higher rates among women are due in part to their susceptibility to certain rarer diseases, such as coronary artery dissection, where around eight out of ten cases are women.
They warn these rare conditions are going seriously under-researched.
Amongst the conditions which young women are prone to - and which experts say need more research - are valvular heart disease, dissection of the coronary artery and heart complications associated with lupus.
Professor Peter Weissberg, BHF medical director, said: “We’ve seen heart attack deaths plummet in older people in the last 20 years but I suspect these rarer forms of heart disease have stayed pretty stable… We’re doing a lot of research on the more common heart problems that affect people in middle to later age and are having great success at that and now we need to focus our attention on some of the more rare conditions that affect younger people.”
The number of young women living with cardiovascular disease has remained higher than men for several years. In 2006 there were 760,000 women living with heart conditions, compared to 580,000 men.
It is estimated that one in every four men and one in every six women die from heart disease.
Dr Bernard Prendergast, honorary secretary of the British Cardiovascular Society and a consultant cardiologist at Oxford’s John Radcliffe hospital, said: “Traditionally women have been under-represented in clinical research. Men and women differ and it doesn’t follow that research into male patients are relevant to women. Often when you divide men and women in a study the results are different.
“Valvular heart disease is under-researched as well as rare conditions and congenital heart disease. Rightly so, the dominant research has been in ischaemic heart disease [angina] because that’s the number-one killer. But the epidemic of that is falling and other diseases are taking their place.”
Michelle White was diagnosed with a mitral valve prolapse - a degeneration of a valve on the left of the heart - when she was 26. She had had symptoms for more than a decade but doctors put her teenage fainting episodes down to exam stress. The athletic mother of three from Manchester has twice had open heart surgery and is fitted with a pacemaker. Doctors say she is lucky to be alive.
“I was at work and I blacked out”, she recalls. “After a series of tests they discovered I had a congenital heart condition and my heart was stopping, meaning I blacked out. I’m not overweight, I was very athletic - in my wildest imagination, a heart problem hadn’t occurred to me. The doctors didn’t have a clue why I had this - they were rolling with the punches like me. The first thing they said was I must’ve had rheumatic fever as a child, but I didn’t, and there was no history of heart disease in the family. So why did I have it? Nobody knows. I still have no idea how I could be walking around as a young person and collapse and die at any time. They said I was near-enough impossible - I was a walking miracle.”
Last night Ms White appeared for the first time in a BHF television campaign, aimed at smashing the unhealthy male stereotype.
Almost 180,000 people die every year from circulatory system failures in the UK - and 91,550 of them are women. This higher number of women is not thanks to the younger cohort, however, but largely because of the high number of fatal strokes in women over-75.
Dr Martin Landray, an epidemiologist at Oxford University, says that one reason for a knowledge gap between the sexes is that drug trials and medical research into heart conditions still struggle to include as many women as men. “A typical study of cholesterol lowering drugs might have fewer than one in five of the people in it being women,” he said , adding that when he conducted a large-scale trial of cholesterol treatment last year, almost half as many women volunteered to take part than men. “Women need to recognise that heart disease is important and the way to understand if women respond in the same way to drugs as men, is getting more women into these studies. It’s a recognised problem that women are under-represented in clinical trials. There may be social reasons for that, such as maybe many of the women are fundamental to the care of those around them. Or it may be that the whole concept of clinical trials seem more frightening to women than men. Or it may be the nature of the invite and approach comes across as less friendly to women than men.”
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