Pictured above from left – Jaimi Fraser (Heart Foundation), Mami Hynds, Leonie Hynds, Dr Nikki Earle, Robyn Hynds, Chloe Milloy (Heart Foundation).
Alongside well-known heart disease risk factors such as high cholesterol, high blood pressure, diabetes, obesity and smoking, women have some sex-specific risk factors that put them at higher risk of heart disease.
These include menopause, gestational diabetes, pre-term delivery and a genetic condition known as familial hypercholesterolaemia.
Dr Nikki Earle, the latest recipient of the Heart Foundation Hynds Senior Fellowship, says many of these risk factors aren’t widely understood.
“Currently, the cardiovascular risk assessment models that are done when you go to your GP don’t take any of these factors into account.”
Women can experience different heart symptoms to men. In heart attacks, women are less likely to present with crushing chest pain and more likely to show up with anxiety, shortness of breath, upset stomach, pain in the shoulder, back or arm, or unusual tiredness and weakness.
Dr Earle’s work, which is being generously funded by the Hynds Foundation over the next three years, is aimed at addressing some of this inequity.
Part of Nikki’s research includes a study into undiagnosed familial hypercholesterolaemia, a genetic condition causing very high cholesterol, significantly increasing premature heart disease in women.
By analysing data from more than 4,400 heart attack patients, the research will estimate how many have this condition without knowing it.
Her research will also trial routine screening at Auckland City Hospital, including testing family members of affected patients. Early identification would allow preventative treatment, such as cholesterol-lowering medication, to begin sooner and substantially reduce the risk of future heart events.
Dr Earle is investigating how heart attacks differ by sex, and to identify risk markers for subsequent events that are specific to women.
Using data from more than 35,000 heart attack cases, the study will examine differences between men and women in symptoms, treatment, and outcomes.
It will also develop recommendations to better incorporate female-specific risk factors into clinical guidelines, helping to improve prevention and care for women.
Dr Earle says it’s been surprising to see how big the research gap is for women’s specific conditions when it comes to heart disease.
Women on average have their first heart attack seven years later than men. But after menopause, their risk is heightened because of the loss of the heart-protective effect of oestrogen.
“When you compare the outcomes for men and women all the way up to age 75, women actually have far worse outcomes. And the situation is even more dire for Māori and Pasifika women,” she says.
“More women die or are re-admitted to hospital for cardiovascular causes than men. And that’s particularly bad for younger women (aged under 55) compared with younger men. Our research is trying to understand why this is.”
Thank you to the Hynds Foundation for generously supporting inspiring researchers, like Dr Earle, and helping make their vital work possible. The Heart Foundation is incredibly grateful for their ongoing contribution in the fight against heart disease.