Cardiovascular Disease in Women: Time for ActionOpen Access

Introduction

This special issue focuses on cardiovascular disease (CVD) in women. CVD is the number 1 killer of women in the United States. Women of any age may be diagnosed with a heart condition, and while some heart disease is hereditary or congenital, many types are preventable.

When we announced this special issue, the response was overwhelming. Most submissions were both stimulating and of excellent quality. The Editorial Board and I did our best to choose those which best fit this feature issue and represent the range of challenges facing women with heart disease.

Unfortunately, not only is the rate of atherosclerotic disease and related events high in women, but women are also far less likely to recognize and promptly report symptoms (1). Culturally, women often underestimate symptoms, such as palpitations, chest pain, dizziness, or even fatigue, and often put the needs of others before themselves (2). At the same time, the medical system also carries an implicit bias, and women presenting with atypical symptoms are often misdiagnosed or offered less invasive assessment options. Even after a cardiovascular event, women are less likely to attend cardiac rehabilitation or take their medication regularly or make the lifestyle changes necessary for good health. Family, friends, and the medical team all have an important role to play in empowering and supporting women living with heart disease.

The global burden of cardiology includes atherosclerotic disease, but there are also unique risks to women. For example, in addition to being the number 1 cause of mortality in women in Africa (3), peripartum hypertensive heart disease is the top cause of maternal mortality worldwide, including in the United States, and is significantly related to CVD in pregnancy, mandating improved systems of pre-natal detection of CVD, intrapartum monitoring, and post-partum as well as long-term cardiovascular follow-up.

These needs have led to the establishment of dedicated care programs and hospital units as well as training pathways for clinicians to further the expertise in CVD in women.

This issue is separated into 3 parts: 3 stimulating Viewpoint papers by Drs. Park, Reza, and Martinez to engender discussions regarding women’s cardiovascular health, cases of women of all ages presenting with CVD, and, last, a mini focus issue on peripartum cardiomyopathies.

Most importantly, we would like to express our gratitude to Dr. Athena Poppas, the incoming president of the American College of Cardiology, for her vision on women’s health in the Leadership Page, and the most recent generation of female cardiovascular fellowship graduates now practicing in our midst and ready to change the trajectory of CVD in women.