Women in Scotland under-estimate heart attack risk

Ischaemic heart disease kills nearly three times as many women as breast cancer in Scotland. But our new survey has found that Scottish women are more concerned about their risk of breast cancer (57%) than their risk of ischaemic heart disease (51%).

The survey of around 1,000 Scottish women, conducted by YouGov, comes as we publish a new report ‘Bias and Biology’ today (Monday 30 September 2019), highlighting the urgent need to raise awareness of heart disease in women. It also raises the issue of inequalities between the sexes, showing that too many women are dying needlessly or recovering poorly from a heart attack because they may not receive the same treatment and care as men.

Every year, ischaemic heart disease, including heart attacks and angina, kills around 2,600 women in Scotland – that’s seven women every day. There are currently around 100,000 women in Scotland who are living with ischaemic heart disease. But too many women are not aware that they are at risk. The common perception that heart disease affects men leads to women being less likely to recognise the symptoms of a heart attack and more likely to delay seeking help, which can cost lives.

The Scottish Government recently announced its commitment to a Women’s Health Plan which will include action to address inequalities for women with heart disease – a move we welcome. The appointment of a Women’s Heart Champion for Scotland should be considered as a next step, to further ensure the issue is prioritised, raising awareness among women of the risks and symptoms and promoting equality of timely diagnosis and treatment within the healthcare system.

Professor Colin Berry, Professor of Cardiology and Imaging, University of Glasgow and Golden Jubilee National Hospital Director of Research and Development, says: “At every stage – from the moment they experience symptoms through to their rehabilitation – women with heart disease can face disadvantages. This has to change.

“We know that women often wait longer before calling 999 after first experiencing heart attack symptoms. But that delay can dramatically reduce the chance of survival. Women may be less likely to receive a timely diagnosis and, even after the event, women are less likely to be offered cardiac rehabilitation to improve their recovery. It is incumbent on us all to work together to address these issues to help save and improve lives.”

Jen's story

Jen Stevens from Edinburgh (pictured) collapsed after a heart attack at the age of 42. She had been having symptoms for some time and was diagnosed by doctors at Edinburgh Royal Infirmary thanks to a new test, developed through research funded by the BHF.

“I was having symptoms for six weeks before it happened,” explains Jen. “I remember a crampy feeling across my chest and being slightly out of breath. I never for one moment suspected a heart attack. I thought it was a bit of stress or a chest infection.”

When someone has a heart attack, a protein called troponin is released into the blood stream by damaged heart cells. However women can release lower levels of troponin, leading to some patients not being diagnosed with a heart attack. BHF-funded researchers at the University of Edinburgh have developed an even more sensitive troponin test, which is helping to diagnose more heart attacks, particularly in women. Jen Stevens was one of those patients diagnosed using the new test.

“When I was taken into hospital, I didn’t know at the time that I was getting a troponin test,” Jen continues. “Within ten minutes, a nurse appeared and told me I’d had a cardiac episode. One of my arteries was almost completely blocked. Thankfully I have now made a complete recovery. I’ve changed my lifestyle and would advise anyone that if they’re even slightly worried about anything, please get it checked out. I was incredibly lucky. It could have been very different.”

Heart attack symptoms

We want everyone to be more aware of the most common symptoms of a heart attack:

• Central chest pain or discomfort in your chest that suddenly occurs and doesn't go away. It may feel like pressure, tightness or squeezing.
• For some people the pain or tightness is severe, while other people just feel uncomfortable.
• Pain similar to that of indigestion is also a common symptom.
• Pain which radiates down your left, or both arms, or to your neck, jaw, back or stomach.
• Feeling sick, sweaty, light-headed or short of breath.

A heart attack is a medical emergency and can be life threatening. Anyone experiencing any of these symptoms should phone 999 immediately for an ambulance.

Kylie Strachan, BHF Scotland’s Policy and Public Affairs Manager, says: “Women are suffering and dying because of the inequalities they face in the diagnosis and treatment of heart disease. Our survey findings confirm that we need to improve understanding of the risks for women and increase their awareness of the symptoms of a heart attack. We must also promote equality of treatment for women with heart disease within the healthcare system, at every point in their journey.

“The Scottish Government’s commitment to a Women’s Health Plan is an important first step and a welcome one. We believe this work could be accelerated and amplified with the appointment of a Women’s Heart Champion and look forward to working collaboratively to help ensure more women’s lives are saved, and women make a better recovery from heart disease in the future.”

Chief Medical Officer for Scotland Dr Catherine Calderwood said: “The number of deaths from heart disease has reduced significantly over recent years due to improved medical care, reduced smoking and increased awareness that lifestyle improvement plays a significant part in saving what was previously seen as an ‘inevitable’ death.

“The Scottish Government is aware that improvements in health care need to recognise the specific needs of women with heart disease.

“The Scottish Programme for Government 2019/20 commits to establishing a Women’s Health Plan to tackle women’s health inequalities. This will include the reduction of inequalities in health outcomes for women’s general health, including work on cardiac disease.”

Download our Bias and Biology briefing