Study Highlights Need for Gender-Specific Risk Assessment For Heart Disease

The scoring system used to predict a person’s risk of cardiovascular disease needs an upgrade to ensure it accounts for risk factors specifically that affect women. According to a study published today in Frontiers in Physiology, the Framingham Risk Score (FRS) analyzes six factors to determine a person’s likelihood of experiencing a heart attack or stroke within the next ten years. The six factors are age, gender, diabetes, cholesterol, smoking habits, and blood pressure. 

Even though the system does account for gender, researchers say it has never considered the more specific factors within the female body that significantly affect their risk of heart attack or stroke. Researchers say that anatomically, female and male hearts are different. For instance, female hearts are smaller and have thinner walls. Yet, the diagnostic criteria for certain heart diseases are the same for women and men, meaning that women’s hearts must increase disproportionally more than men’s before the same risk criteria are met. 

Researchers say that the current design of FRS means multiple cardiovascular conditions are overlooked and underdiagnosed in women. When it comes to cardiovascular diseases, in particular, the prevalence of these diseases is higher in men than women. Still, several studies have shown that women are less likely to be diagnosed during a routine exam, get diagnosed at an older age, and have more severe symptoms than men. The researchers suggest leveraging large data sets and incorporating machine learning into the FRS to help improve the diagnosis for women. 

Medical research has been criticized for collecting data on particular conditions or medications and then generalizing results to women. Heart diseases kill more women every year compared to all types of cancers, researchers say.  

In men, heart attack symptoms commonly result in chest and arm pain and chest tightness. In women, the symptoms are often different: shortness of breath, reflux, nausea, vomiting, and a sensation that their bra might suddenly feel too tight. Dismissing these subtler symptoms means delaying critical treatment. During a heart attack, time equals muscle damage. The more time that passes, the more damage that occurs, putting women at a higher risk of having significant complications from a heart attack. 

Researchers suggest that women should be encouraged to get routine mammograms and breast exams after age 40. They should also consult cardiologists regularly, which could lead to getting earlier cardiovascular support.