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New heart report: The heart attack in women is symptomatically different


As in previous years, more women than men die when considering heart diseases, as documented by the new German Heart Report 2016. In 2014, 110,915 women versus 97,061 men died of coronary artery disease (CHD) / heart attack, heart valve disorders, arrhythmia, heart failure (congestive heart failure) and congenital heart defects. The heart report is published annually by the German Heart Foundation together with the medical associations for cardiology (DGK), heart surgery (DGTHG) and pediatric cardiology (DGPK) and can be requested free of charge at www.herzstiftung.de/herzbericht.

Particularly noticeable is the significantly higher mortality rate among women with cardiac insufficiency, cardiac arrhythmias and heart valve disorders. "Women with these heart diseases obviously have a less favorable prognosis than male patients," emphasizes cardiologist Prof. Dr. med. Thomas Meinertz, CEO of the German Heart Foundation. "These strong differences in mortality have existed for years, they contrast with the inpatient incidence of illness, which is significantly higher in men, and should be the reason for more detailed examinations in order to rule out bottlenecks in the medical care of heart patients." 100,000 inhabitants / PE) with heart failure for women 71.2% above the value of men: the death rate for women was 68.9 per 100,000 PE, for men 40.3. In absolute numbers: 28,513 women died of heart failure compared to 16,038 men. In the case of cardiac arrhythmia, the death rate for women was 48.2% higher (women: 37.8; men: 25.5): 15,620 women died of rhythm disorders compared to 10,154 men. In heart valve diseases, the death rate for women was 54% higher than for men. An exception are CHD / heart attack, which generally have a significantly higher number of deaths among men than among women.

Are women treated less frequently and treated less well than men?
For the mortality gap between women and men, the question arises of differences in medical care (diagnostics, therapy). In the care of patients with cardiovascular diseases - also taking into account the higher incidence of CHD in men - it is evident that significantly fewer women receive a left heart catheter examination (LHK): in 2015, 35.4% of LHK patients were women compared to 64, 8% men. The proportion of women in percutaneous coronary interventions (PCI) (balloon dilatation, stent insertion) is also low: in 2015, only 28.3% of PCI patients were women. The situation is similar for bypass operations: of 51,941 procedures (2015), women with 11,521 (22%) procedures were operated significantly less often than men (78% with 40,420 bypass operations). The prescribed daily doses of medication also show that men receive significantly more medications for the treatment of cardiovascular diseases than women: in men 45% of the prescribed medications are cardiovascular medications, in women the proportion is 25% (TK Health Report 2016).

"Future analyzes will have to clarify whether there is a connection between these differences in the medical care of cardiac patients and the less favorable prognosis for women with cardiac insufficiency, valve disorders and rhythm disorders. In any case, women have to be diagnosed and therapeutically treated according to their heart disease to such an extent that an imbalance in mortality is not due to differences in care, ”emphasizes the heart specialist. However, women-specific peculiarities such as hormonal differences, effects of medication due to metabolic processes, different anatomy of the small coronary arteries and the reduced perception of heart attack symptoms in women, especially in old age, should be included in this analysis. (Guest contribution German Heart Foundation)

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