Heart disease is a feminist issue

Diabetic women get less intensive treatment for their heart disease than men do.

Topics: Broadsheet, Science, Health, Love and Sex,

If I hadn’t already been a feminist, my awakening would have come in September 2000, when my mother lay dying in a hospital. She’d gone in with a massive heart attack, and tests revealed she’d had several smaller ones previously — something none of us, including Mom, had known about. I asked the doctor how that was possible, and he gave me two answers. First, she had Type 2 diabetes, and diabetic neuropathy can interfere with people’s ability to recognize heart attack symptoms. Second, women’s heart attack symptoms can be different from men’s — we might feel pain in the back, jaw or stomach instead of the chest, for instance, and the radiating pain down the left arm we all hear about doesn’t show up as often in women. Why, I asked the doctor, had I never heard that before, at 25 years old? “Well,” he said, “until about 20 years ago, they just didn’t test much on women. The assumption was that it would be the same for them as for men.”

Try that for a kick in the gut. They just didn’t test much on women. Until, I guess, it occurred to the medical community that the No. 1 killer of women ought to be studied in women. Worse yet, the information they did have by the time my mom died wasn’t even common knowledge for some reason — and still isn’t. (An Australian study was released just last week that showed most women still think breast cancer, not heart disease, is their No. 1 potential killer. If women don’t even know that much, it’s not a wonder so many are surprised to learn we have our own distinct heart attack symptoms.)



And when I read today that women with Type 2 diabetes and heart disease are given less intensive medical treatment than men, I was furious all over again. Dr. Ioanna Gouni-Berthold, leader of a recent study that examined almost 45,000 people with Type 2 diabetes, said, “Our study shows that in patients with diabetes, there is a clear disparity between men and women in the control and treatment of important modifiable risk factors for cardiovascular disease.” Among the subjects with cardiovascular disease, women were more likely than men to have uncontrolled high blood pressure and blood glucose levels, and though they were more likely to have high cholesterol, they were less likely to be given medication for it.

While some of that disparity might be attributed to differences in patient compliance, you can’t comply with a nonexistent order to take medication you weren’t prescribed. There’s clearly a problem with the doctors studied being less aggressive in their treatment of women. And this research, according to the article, “probably explains why death from heart disease is being lowered in male diabetics but not among females.” Suddenly, I’m feeling a sharp pain in my stomach, as if I’ve been kicked there, once again.

Kate Harding is the co-author of "Lessons From the Fatosphere: Quit Dieting and Declare a Truce With Your Body" and has been a regular contributor to Salon's Broadsheet.

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