The European Society of Cardiology (ESC) is working with the National Cardiac Societies of its 53 member countries on a project to raise awareness of the disturbing gender gap in cardiovascular disease (CVD). In partnership with the European Heart Network (EHN) and the World Heart Federation (WHF), the ESC has developed the Women@Heart contest in which national societies submit ideas for public awareness campaigns aimed at informing both health professionals and women of the dangers of complacency about CVD.
Cardiovascular disease (CVD) is the primary cause of death amongst women, killing 8.6 million worldwide every year – more than all forms of cancer combined. But because the traditional view of CVD is male-oriented, many women remain unaware of the specific risk factors and assume they are less likely to suffer from stroke, heart failure or heart attack. Evidence shows that this assumption is dangerously incorrect, and that there are significant gender differences in both symptoms and disease progression.
The contest attracted a number of very high quality entries, with the Latvian Society of Cardiology declared the winner by a panel of experts. The submissions from the Society of Cardiology of the Russian Federation and the Spanish Society of Cardiology were commended and awarded second and third place respectively. Each of the top three receive a financial contribution to the cost of running their campaigns, while campaign templates and materials are freely available to other national societies to adapt to run within their own countries.
Professor Marco Stramba-Badiale is internationally acclaimed as an expert on CVD in women. He is Director of the Department of Geriatrics and Cardiovascular Medicine at the Instituto Auxologico Italiano in Milan and is a former chair of the ESC’s ‘Cardiovascular Diseases in Women’ task force. “The belief that somehow women are protected from cardiovascular disease is completely wrong,” he says. “Statistics from the World Health Organisation in 2008 actually show that 55% of female deaths in the EU are due to heart attack, stroke and other conditions compared to just 43% of males. There is also a sharp increase in risk in post-menopausal women due to hormone changes and weight gain.”
Research has highlighted the disturbing gender gap in many aspects of CVD. For instance:
•Women have been under-represented in clinical trials with an average female population of 33%
•Only 50% of clinical trials completed since 2006 have reported results by gender
•The majority of drugs available today have been tested for safety and efficacy on men
•Smoking carries a more profound risk for women than men, increasing the heart attack risk by over 50%
•Mortality rates for under-50 females suffering a heart attack are double those for under-50 males
Commenting on these findings, Professor Stramba-Badiale observes, “Thanks to the work began by the ESC back in 2005, researchers are now ensuring better female representation in clinical trials and are beginning to report results by gender. This is good news, but much more needs to be done. It’s crucial that we continue to emphasise that women do not have a lower risk of CVD than men. What they have is a delayed risk and, because the symptoms and progression do not follow the so-called classic pattern, anything we can do to inform women of the danger signs is positive and worthwhile.”
The qualifying criteria for the contest required, as a minimum, that campaigns involved at least two other national or local organisations, and that the outcomes could be measured. Applicants were strongly advised to ensure that their campaigns took full advantage of existing support materials produced by the ESC, EHN and WHF. Summarising the top three entries:
•The Latvian entry proposed a campaign aimed at both medical professionals and the general public. With a theme of ‘It’s a Red Alert’, the campaign targets activities around International Women’s Day and Mother’s Day to highlight the major risk to women from CVD. One of the campaign elements is to hold a themed day at major shopping malls in which store windows, staff and customers are ‘dressed’ in red.
•The Russian entry proposed a one year programme of two day events in major cities, of which day 1 was to brief up to 700 medical professionals with day 2 dedicated to hosting up to 2,000 women. The campaign aims to provide education of the risk factors as well as screening facilities to give an overall health assessment and measure aspects such as body mass and cholesterol. Women considered to be in the higher risk category will receive an individual one-to-one session with a doctor.
•The Spanish entry proposed a campaign of events in the major cities of Madrid, Barcelona and Seville focused on educating health professionals about the serious gender gap in CVD diagnosis and treatment. The Spanish Society of Cardiology particularly wants to address the relatively low number of female referrals for procedures such as stent insertion.
The ESC project follows on from the successful Red Alert for Women’s Heart research and conference undertaken as part of the EU-funded EuroHeart project. A similar programme was created by the American Heart Association called Go Red for Women and is run globally by the World Heart Federation. Both aimed to highlight the disturbing gaps in public awareness of the risk factors to women from CVD. The objectives of the Women@Heart contest are fully aligned with the ESC mission to reduce the burden of cardiovascular disease in Europe.