Coronary artery disease in women: an unsolved dilemma

Racial Disparities in Cardiovascular Risk and Cardiovascular Care in Women

PURPOSE OF REVIEW

Research on sex and gender aspects cardiovascular disease has contributed to a reduction in cardiovascular mortality in women. However, cardiovascular disease remains the leading cause of death of women in the United States. Disparities in cardiovascular risk and outcomes among women overall persist and are amplified for women of certain ethnic and racial subgroups. We review the evidence of racial and ethnic differences in cardiovascular risk and care among women and describe a path forward to achieve equitable cardiovascular care for women of racial and ethnic minority groups.

RECENT FINDINGS

There is a disproportionate effect on cardiovascular outcomes in women and certain racial and ethnic groups in part due to disparities in triage, diagnosis, treatment, which lead to amplification of inequalities in women of minority racial and ethnic background. Data suggest gender and racial bias, underappreciation of nontraditional risk factors, underrepresentation of women in clinical trials and undertreatment of disease contributes to persistent differences in cardiovascular disease outcomes in women of color. Understanding the myriad of factors that contribute to increased cardiovascular risk, and disparities in treatment and outcomes among women from racial/ethnic minority backgrounds is imperative to improving cardiovascular care for this patient population.

Reasons for delay in seeking healthcare among women with acute coronary syndrome from rural and urban areas in Jordan

We aimed to explore reasons for delay in seeking healthcare among women with acute coronary syndrome (ACS) for the first time from urban and rural areas in Jordan. A qualitative descriptive design was used through face-to-face interviews with 33 women. Themes that explained why women delayed seeking healthcare when experiencing ACS were: Knowledge deficit about coronary artery disease; the effect of disparity in healthcare services on women decision; and life priorities of women during the ACS attack. Educational needs should be addressed based on variations in both areas.Supplemental data for this article is available online at https://doi.org/10.1080/07399332.2021.1955889 .

Factors Associated with Prehospital Delay among Men and Women Newly Experiencing Acute Coronary Syndrome: A Qualitative Inquiry

Background

Delaying seeking health care for patients with acute coronary syndrome (ACS) causes high mortality and morbidity with variations among men and women regarding reasons for this delay.

Objectives

This study explored factors associated with prehospital delay among men and women experiencing acute coronary syndrome for the first time in Jordan.

Methods

35 men and 33 women with ACS admitted and treated at the coronary and postcoronary care units.

Results

Themes emerging from the data are knowledge about ACS, the resources related to health care, and concerns around family wellbeing. Owing to the traditional roles of men and women within the family, women felt responsible for maintaining the family, assisting in the financial conditions, and supporting family coherence by delaying hospitalization. Men were worried about the structural safety and maintenance of the family. Conclusion and Implications. Prehospital delay is common among first-timer ACS patients from both sexes, and thus, increasing awareness about ACS among the public from all age groups is necessary. Availability of specialized health care centers and equity in health care services are vital to improve public confidence in these health care settings and health outcomes.