10 Unanswered Questions Leave Millions of Lives Hanging by a Heartbeat

11/17/2011 09:02 am ET
  • Kathy Kastan Director, Duke Medicine's Women's Health and Advocacy Initiative, Past President, Emeritus, Womenheart; Patient Advocate; Psychotherapist

Because heart disease affects so many people, one may think that we as a nation have put the time and resources into figuring out how to reduce its devastating impact. There is, however, an element of flying blind when it comes to women and heart disease.

Women's heart disease is often misdiagnosed and mistreated due to a lack of adequate and relevant research studies. I am one of the millions of women who got caught in the gray area. My experience with heart disease could have been completely different -- and in fact better -- had these questions been answered previously I might not have been misdiagnosed nor would the treatments and procedures have failed or caused complications which lead to my bypass. In fact, it took three cardiologists to finally get me on the right medication regimen before I could get my life back.

Eight million American women live with heart disease and the prediction is that in 10 years there will be 12 million or more women living with heart disease. It kills more women -- nearly 367,000 total -- than men every year and remains the leading cause of death for American women of all ages. Too many American women are being treated inappropriately because of inadequate or absent cardiac research data.

Public and private healthcare dollars are being wasted on these ill-informed diagnostic and treatment decisions. Ignorance is expensive and often fatal. We can do better for American women. We can save lives and save dollars at the same time.

I'm not saying that strides haven't been made. A recent National Institutes of Health (NIH) study found that the type of heart disease that affects many women is more often small vessel disease -- fundamentally different than the type that affects men and commonly missed by angiograms, the "gold standard" cardiac diagnostic test. That's great news and hopefully will save lives. But there remain critical unanswered questions when it comes to women and heart disease.

Recently, I supported two leading health groups as they released a groundbreaking report on heart disease research in women. WomenHeart: the National Coalition for Women with Heart Disease and the Society for Women's Health Research (SWHR) published "The 10 Q Report: Advancing Women's Heart Health Through Improved Research, Diagnosis and Treatment," which identifies the top 10 unanswered questions related to the development, diagnosis and treatment of heart disease in women. These questions are shockingly basic. For example:

* Why are women age 50 and younger more likely to die following a heart attack than men of the same age?

* Why do women receive significantly fewer referrals for advanced diagnostic testing and treatments for heart disease than men, and how can the referral rate for women be increased?

The questions cover effectiveness of risk assessment and diagnostic tools, the differences in risk and in effectiveness of therapies for men and women, and the need for improved understanding of cardiovascular disease in women. Answering these questions through targeted research could cut the number of women who die prematurely of heart disease by 50 percent over the next decade.

The report lays out a blueprint for a research agenda that can also help save American taxpayers millions of dollars in inappropriate and misdirected healthcare costs and give doctors the knowledge they need to properly treat the disease. To put it simply, answering the top 10 unanswered research questions of The 10 Q Report can lead to better decision-making, decreased cardiac deaths for women and real cost savings.

Why should you care? Because there are things you can do to help. Write to you Senators and Members of Congress and ask them to place heart disease among women at the top of the nation's healthcare agenda. Lawmakers can ask NIH to re-direct current research dollars to focus on these 10 critical research questions.

If you are a woman offered the chance to take part in research relating to heart disease, take advantage of that opportunity. Currently, women make up only 25 percent of participants in heart-related research studies.

By playing a role in helping to generate answers, you never know what could happen. Ten years down the road, unanswered questions could become powerful life-saving solutions and yours may be one of the lives saved.

Kathy Kastan is the author of From the Heart: A Woman's Guide ot Living Well with Heart Disease (Da Capo Lifelong Books, 2007), President of WomenHeart: The National Coalition for Women with Heart Disease, and Chair of the Northwest Region of the American Heart Association.