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Last Updated: Friday, 2 September 2005, 10:13 GMT 11:13 UK
Heart disease missed in women
Women are actually more at risk
Coronary heart disease in women is under-diagnosed, under-treated and under-researched, an expert has said.

Cardiovascular disease is the leading cause of death for both sexes world-wide, exceeding the number of deaths for all cancers combined.

But writing in the British Medical Jornal, cardiologist Ghada Mikhail said it is still considered a male disease.

In fact, in Europe cardiovascular disease kills 55% of women, but only 43% of men.

Appropriate access to diagnosis and treatment are desperately needed to tackle this potentially fatal disease
Ghada Mikhail

Dr Mikhail, based at North West London Hospitals and St Mary's Hospital Trusts, said many women were unaware that coronary heart disease is their main killer - their biggest fear is breast cancer.

But even more worrying, she said, was the apparent lack of awareness of cardiovascular disease in women among healthcare professionals.

Dr Mikhail said women may have less common symptoms, such as back pain, burning in the chest, abdominal discomfort, nausea, or fatigue, which makes diagnosis more difficult.

They are also less likely to seek medical help, and tend to present late in the process of their disease.

In addition, they are less likely to have appropriate investigations, such as coronary angiography, which can delay the start of effective treatment.

She said research into heart disease also tended to focus on men - making it difficult to draw definitive conclusions about how to manage the condition in women.

Women typically account for less than 30% of participants in most trials.

Action needed

Dr Mikhail called for more research to take account of the possible differences between the sexes.

She also said: "Better awareness and education, earlier and more aggressive control of risk factors, and appropriate access to diagnosis and treatment are desperately needed to tackle this potentially fatal disease."

Belinda Linden, of the British Heart Foundation, agreed that action was badly needed.

She said: "For nearly 15 years, the BHF has been campaigning to raise awareness of the risk of heart disease among women and the need for equal representation in treatment and research trials.

"Gender should not be a factor on which to base treatment or care."

Ms Linden said BHF research suggested that the vast majority of women (73%) have never talked to their GP or practice nurse about heart disease and that only one in ten (11%) perceive women to be at most risk of heart disease.

"It's vital that we address this because being more aware of your heart health now, could prevent problems in the future."

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