Heart disease and stroke combined is the leading cause of mortality in women, claiming 8.6 million lives per year globally. The special women’s health sessions of WCC 2010, under the umbrella of the 3rd International Conference on Women, Heart Disease and Stroke, addressed existing gender differences in cardiovascular disease (CVD) assessment, therapy and outcomes, highlighting the need for more women-specific research and public education.

There is an obvious gap between perception of heart disease and reality among women. Women, unlike their opposite sex counterpart, are more prone to non-cardiac chest pain. Almost half of myocardial infarctions (MIs) in women present with shortness of breath, nausea, indigestion, fatigue and shoulder pain, though less than 10% of women are knowledgeable of these atypical symptoms. Consequently, women seek medical care later than men, and there tends to be diagnostic confusion in their CVD evaluation and management.

The situation is no better in Asia, with a recent survey conducted by Opinion Health showing that only 10% of Chinese women are aware that heart disease and stroke are the leading causes of death of women. A majority (72%) agreed that men are more likely than women to have a heart attack or stroke, suggesting that the prevailing perception is that these conditions are primarily male diseases.

Women are less likely to have an electrocardiography, and are less likely to enroll in cardiac rehabilitation after an MI or bypass surgery. Women tend to be prescribed less aspirin, beta-blockers, statins, and antiarrhythmic treatment, and undergo cardiac catheterization, percutaneous coronary angioplasty and coronary artery bypass graft (CABG) procedures less frequently. Importantly, mortality from CABG among younger women is double that among men, and mortality associated with acute MI among women aged less than 65 years is almost twice as high that of similarly aged men.