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CHÉOS Scientist closing the gap in women’s heart health

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CHÉOS Scientist Dr. Karin Humphries, scientific director of the B.C. Centre for Improved Cardiovascular Health and associate professor for the Division of Cardiology at UBC, provided her expertise to a report recently released by the Heart and Stroke Foundation. Coinciding with the kick off of Heart Month, the report highlights the gaps in our understanding of women’s cardiac health. The report describes the issues plaguing women’s heart health as being defined by ‘unders’ — under-studied, under-diagnosed, under-treated, under-supported, and under-aware.

Dr. Humphries is a leader in women’s heart health; her research focuses on sex and gender differences in diagnosis, treatment, and outcomes in coronary artery disease. As part of her Heart and Stroke Foundation Professorship in Women’s Cardiovascular Health she plays a key role in defining and directing federal funding to support this type of research.

Important differences between how men and women experience and develop cardiovascular disease have been overlooked to the detriment of women’s health. This discrepancy stems from a lack of consideration of sex and gender differences and exclusion of female participants in clinical research — two out of every three clinical research studies are in men.

“Sex and gender blinders have led to too many women dying unnecessarily,” says Dr. Humphries in the report.

Female-specific risk factors, differences in physiology and pharmacokinetics, women’s neglect of their own health, and varying symptoms at presentation are just some of the sex and gender differences that exist. For example, though men and women both experience chest pain when having a heart attack, women often describe the pain differently and are also more likely to present with nonspecific symptoms like jaw and back pain and nausea. These early warning signs are often overlooked by the women experiencing them and their physicians. According to the report, early signs of heart attack were missed in 78 per cent of women; this delays treatment and may contribute to worse outcomes for women.

Disparities in diagnosis and treatment can’t be attributed to these differences alone. Dr. Humphries’ recently published study with fellow CHÉOS Scientists Drs. Martha Mackay and Eric Grafstein assessed whether levels of cardiac troponin (cTn), a biomarker used in diagnosis of myocardial infarction, could account for differences in heart attack diagnosis, treatment, and outcomes for men and women presenting to the emergency department with chest pain. Though a single diagnostic cut-point on the 99th percentile for cTn levels in the overall population is commonly used, women tend to have lower cTn levels, making it less likely that they meet this diagnostic criteria. The study found that a sex gap in diagnosis, treatment, and outcomes could not be explained by cTn levels. Even when women presented with chest pain and cTn levels above the 99th percentile, they were still less likely than men to be diagnosed with and treated for myocardial infarction.

Dr. Humphries will be discussing efforts to close the gap of under-diagnosis and under-treatment of women with cardiovascular disease at the upcoming Work in Progress seminar series taking place on February 14. She will be examining a trial to evaluate the diagnostic and prognostic implications of using sex-specific cut-points for cTn in the diagnosis of myocardial infarction and other heart injuries.

The talk will be held in the Hurlburt Auditorium at St. Paul’s Hospital from 12:00 PM to 1:00 PM.

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