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Awareness of heart disease as the leading killer of women drops among younger women and minorities

  • September 24, 2020
American Heart Association special report highlights trends in awareness among women in the United States regarding heart disease.

Woman having a pain in the heart area with red alert accent on white backgroundAmerican Heart Association special report highlights trends in awareness among women in the United States regarding heart disease.A newly published special report shows that women’s awareness that heart disease is their leading cause of death has declined significantly over the past ten years. The report indicates that the number of women aware that heart disease was the leading cause of death for women dropped from 65 percent in 2009 to 44 percent in 2019, according to the survey published by the American Heart Association journal Circulation. The decline in awareness was observed across all racial, ethnic and age groups except women age 65 and older.

Virginia Howard, Ph.D., Distinguished Professor in the UAB School of Public Health’s Department of Epidemiology, is one of the co-authors of the report, “Ten-Year Differences in Women’s Awareness Related to Coronary Heart Disease: Results of the 2019 American Heart Association National Survey.”

“Looking across survey years, in 2009, 2012 and 2019, we found that women who were younger versus older, and non-Hispanic black, Hispanic or Asian versus white had lower awareness that heart disease was the leading cause of death,” said Mary Cushman, M.D., professor of medicine at the Larner College of Medicine at the University of Vermont, and chair of the writing group for the statement.

Cushman and Howard also said the survey indicates that awareness efforts among women of various socioeconomic levels are needed.

“There are groups that could benefit tremendously from enhanced awareness efforts,” Howard said. “Particular attention should be paid to nonwhite women and younger women, as well as those with less education and lower income. We need to help these women understand their risk, and develop healthier lifestyle patterns earlier in life.”

The data are the results of the 2019 American Heart Association National Survey, an online survey of more than 1,500 U.S. women over age 25, conducted in January of 2009, 2012 and 2019.

The 2019 survey included questions on age, sex, race, ethnicity, educational attainment, household income and marital status. Awareness was assessed with the question, “As far as you know, what is the leading cause of death for all women?” Common responses included heart attack/heart disease, cancer (all types), and breast cancer.

The 2019 survey found:

  • Women with high blood pressure were 30 percent less aware that heart disease is the leading cause of death among women, compared to women overall. Only in 2019 were women asked about high blood pressure history.
  • The greatest declines in awareness were among Hispanic women with an 86 percent decline, Black women with a 67 percent decline and women 25-34 years old with an 81 percent decline.
  • Women were more likely in 2019 than a decade ago to erroneously believe cancer is the leading cause of death. Younger women in particular were more inclined to think breast cancer was the leading cause of death among women. 
  • Awareness of heart attack symptomsdeclined among all women. Only 52 percent of women reported that chest pain was a symptom, and 38 percent reported pain that spreads to shoulders, neck or arms was a symptom. Some 28 percent reported shortness of breath as a symptom.
  • Awareness of what to do if having heart attack symptoms was mixed. Knowledge that women need to call 9-1-1 was up from 47 percent in 2009 to 54 percent in 2019, but knowing they should take an aspirin was down from 23 percent to 14 percent over the 10-year period.

covid heart3Virginia Howard, Ph.D., Distinguished Professor, Department of Epidemiology“Alarms should be sounded to address this highly concerning trend among younger women and women of color,” Howard said. “This signals an urgent call for organizations ranging from public health, government and health care professionals to community organizations such as churches and employers to take on the challenge with full gusto to better inform women of their risk for heart disease. Preventing heart disease remains our No. 1 priority — we should be as close as possible to 100 percent awareness.”

Since 1997, the American Heart Association has conducted national surveys among U.S. women to monitor awareness and knowledge about heart disease. Results indicated that awareness of heart disease as the leading cause of death among women nearly doubled from 30 percent to 56 percent between 1997 and 2012. Awareness of heart attack symptoms also increased from 1997 to 2012.

Co-authors of the survey study with Cushman are Christina M. Shay, Ph.D., Virginia J. Howard, Ph.D., Monik C. Jiménez, Sc.D., Jenifer Lewey, M.D., Jean C. McSweeney, Ph.D., L. Kristin Newby, M.D., Ram Poudel, M.S., Harmony R. Reynolds, M.D., Kathryn M. Rexrode, M.D., Mario Sims, Ph.D., and Lori J. Mosca, M.D., Ph.D.