KARACHI: One in four middle-aged adults in Pakistan is living with a cardiovascular disease. Even though men and women are equally susceptible to developing heart diseases — the leading cause of death in the country — the risk of dying or becoming severely unwell from a heart disease is largely underestimated in women due to under-diagnosis and under-treatment.

This was stated by speakers at the 2nd Annual Cardiovascular Conference Pulse 2021 held at the Aga Khan University (AKU).

The speakers noted that contrary to the belief that heart diseases affected only men, women were equally at risk.

In fact, they pointed out, they faced unique sex-specific risk factors related to the early onset of menstruation, menopause and pregnancy-related complications such as preeclampsia.

Women with diabetes were 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’s department of medicine. “Awareness of the differences in clinical presentation of heart diseases among men and women is the key to tackling the burden of disease in the country.”

AKU’s annual cardiovascular conference is told gender matters in manifestation of heart ailments

Women, according to experts, often report atypical cardiac symptoms. 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.

The speakers added that women did not 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.

The women tend to report late at hospitals, thereby increasing their chances of subsequent heart failure and mortality, they added.

60 female cardiologists in country

“In addition to late presentation, treatment in women is less aggressive which results in poorer outcomes,” said Prof Zainab Samad, chair of the 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,” she said.

The speakers noted that there was also a shortage of trained female cardiologists. There were just 60 female cardiologists in a country where almost 30 per cent of all deaths occurred due to cardiovascular diseases.

They pointed out that lack of awareness of heart diseases in women at various levels of the healthcare system along with a shortage of women specialists was a detriment to patients seeking timely care.

The conference was held in collaboration between AKU Medical College’s section of cardiology and department of medicine and was endorsed by the Scientific Council of Women Heart Diseases as part of the Pakistan Cardiac Society and Pakistan Hypertension League.

Published in Dawn, January 27th, 2021