Call for urgent action to tackle cardiovascular disease mortality in women

Experts are calling for urgent action to tackle cardiovascular disease – which is the leading cause of death among women worldwide.

Conditions affecting the heart or blood vessels – such as high blood pressure, heart disease, and stroke – are responsible for 35% of deaths among women globally every year.

In a Commission report published in the journal The Lancet, the researchers said cardiovascular disease (CVD) remains “understudied, under-recognised, underdiagnosed, and undertreated” in women.

They said with women under-represented in clinical trials, strategies to tackle inequities in diagnosis, treatment, and prevention are urgently required to reduce the global burden of CVD by 2030, in line with the United Nations Sustainable Development Goals.

Report author Professor Roxana Mehran, from Mount Sinai Medical Centre in the US, said: “Cardiovascular disease in women remains understudied, under-recognised, under-diagnosed, and under-treated globally.

“Achieving the important target set by the United Nations requires bold, distinct strategies to not only target factors contributing to CVD but also to identify sex-specific biological mechanisms in women.

“Making permanent improvements to the worldwide care of women with CVD requires coordinated efforts and partnerships involving policymakers, clinicians, researchers, and the wider community.”

There are approximately 275 million women around the world with CVD.

Heart disease is the number one killer of women in the UK, with around 28,000 deaths every year.

In 2019, the leading cause of death from CVD worldwide was ischemic heart disease (47%), followed by stroke (36%).

While globally the prevalence of CVD in women has been declining, the researchers said many highly-populated nations including China (10% increase), Indonesia (7%), and India (3%) have seen a rise in the disease.

The said that in women, high blood pressure is the greatest risk factor for CVD, followed by high body mass index and high cholesterol.

The experts said tailored interventions are urgently needed for the most vulnerable populations globally, including women from minority or indigenous populations.

They added that heart attacks and smoking rates are increasing in young women as well, so it is important to reach these groups.

Writing in a linked comment, Dr Ana Olga Mocumbi, of the Mozambique National Institute of Health – who was not involved in the report, said: “In the midst of the Covid-19 pandemic, values of human dignity, solidarity, altruism, and social justice should guide our communities to ensure equitable share of wealth and leveraging of efforts towards the reduction of cardiovascular disease burden in women worldwide.

“The Commission’s recommendations on additional funding for women’s cardiovascular health programmes, prioritisation of integrated care programmes, including combined cardiac and obstetric care, and strengthening of the health systems accords with efforts to bridge the gap for the world’s worst off.

“Such a shift in women’s cardiovascular care would be a major step towards equity, social justice, and sustainable development.”