Insufficient emphasis is placed on cardiovascular disease in women by both women and physicians, and stigmatization of the disease and body weight are major barriers to women seeking treatment. These are among the findings in a study published June 22 in the Journal of the American College of Cardiology.

Researchers from the Women’s Heart Alliance, led by C. Noel Bairey Merz, MD, FACC, interviewed 1,011 U.S. women aged 25–60 years and collected physician survey data from 200 primary care physicians and 100 cardiologists. The goal of the surveys was to determine knowledge, attitudes and beliefs regarding heart disease in women.

The researchers found that 45 percent of women were unaware that heart disease is the number one killer of women in the U.S. Awareness levels were lower in women with lower levels of education and income and in ethnic minorities. Nearly 71 percent of women almost never raised the issue of heart health with their physician, assuming their doctor would raise the issue if there was a problem. Physicians often did not discuss cardiovascular disease because the patient had a more immediate health issue or did not fully report their symptoms, indicating that prevention prior to symptoms was not a priority.

A majority of women reported having a routine physical or wellness exam in the past year – but only 40 percent reported having a heart health assessment. While 74 percent reported having at least one risk factor for heart disease, just 16 percent were told by their doctor that they were at risk. And 63 percent of women admitted to putting off going to the doctor at least sometimes and 45 percent of women canceled or postponed an appointment until they lost weight. Many women reported being embarrassed or overwhelmed by their heart disease and many also cited difficulties in losing weight or finding time to exercise.

Only 22 percent of primary care physicians – and 42 percent of cardiologists – felt well prepared to assess cardiovascular risk in women. Additionally, guidelines for risk assessment were fully implemented by only 16 percent of primary care physicians – and 22 percent of cardiologists.

There is a need to destigmatize cardiovascular disease for women and counteract stereotypes with increased objective risk factor evaluation education to improve treatment by physicians, say the authors. This includes making cardiovascular disease “real” to American women through national action campaigns and using cardiovascular risk assessment to counter stereotypes with facts and valid assessments.