New Heart Report The heart attack in women is symptomatically different

As in previous years, more women than men die when looking at heart disease, as the new German Heart Report 2016 documents. 110,915 women died in 2014 from coronary heart disease (CHD) / heart attack, valvular heart disease, arrhythmia, heart failure (congestive heart failure) and congenital heart disease compared with 97,061 men. The Heart Report is published annually by the Deutsche Herzstiftung in cooperation with the medical societies for cardiology (DGK), cardiac surgery (DGTHG) and pediatric cardiology (DGPK) and can be requested free of charge from www.herzstiftung.de/herzbericht.

Particularly striking is the significantly higher mortality in women with heart failure, cardiac arrhythmia and valvular heart disease. "Women with these heart diseases obviously have a less favorable prognosis than male patients", underlines the cardiologist Prof. Dr. med. med. Thomas Meinertz, Chairman of the Board of the German Heart Foundation. "These strong mortality differences have existed for years, contrasting with the incidence of inpatient disease, which is significantly higher in men, and should be the subject of more detailed research to rule out shortages in the care of cardiac patients." In 2014, the death rate (died per 100,000 inhabitants / person) in women with cardiac insufficiency 71.2% above the value of men: in women the death rate was 68.9 per 100,000 PE, in men 40.3. In absolute terms: 28,513 women died of heart failure compared to 16,038 men. The incidence of cardiac arrhythmias was 48.2% higher in women with cardiac arrhythmias (women: 37.8, men: 25.5): 15,620 women died from arrhythmias compared with 10,154 men. In heart valve diseases, the death rate of women was 54% higher than in men. An exception is CHD / cardiac infarction, which generally has a significantly higher number of deaths in men than in women.

A heart attack is usually symptomatic in women differently than in men. Image: Robert Kneschke - fotolia

Are women treated less often and less well looked after than men??
The mortality gap between women and men raises the question of differences in medical care (diagnostics, therapy). For example, in the care of patients with cardiovascular disease - even taking into account the higher incidence of CHD in men - significantly fewer women receive left heart catheterization (LHK): in 2015, 35.4% of LHK patients were women versus 64, 8% men. The proportion of women in percutaneous coronary interventions (PCI) (balloon dilatation, stent delivery) is also low: in 2015, only 28.3% of PCI patients were women. Similarly, the bypass operations: Of 51,941 procedures (2015), women operated with 11,521 (22%) procedures significantly less frequently than men (78% with 40,420 bypass operations). In addition, the prescribed daily doses of medication show that men receive significantly more drugs for the treatment of cardiovascular diseases than women: in men, 45% of the prescribed drugs are cardiovascular drugs, in women, the proportion is 25% (TK Health report 2016).

"Whether there is a relationship between these differences in cardiac care and the less favorable prognosis for women with heart failure, valvular disease, and arrhythmias need to be clarified in future analyzes. In any case, women need to be given sufficient diagnostic and therapeutic support to treat their heart disease so that a morbid imbalance is not due to differences in care, "says the cardiologist. However, women's specificities such as hormonal differences, differences in the effects of drugs due to metabolic processes, different anatomy of the small coronary arteries and the reduced perception of heart attack symptoms in women, especially in old age, should be included in this analysis. (Guest contribution German Heart Foundation)