Women's Heart Health Hindered by Social Stigma About Weight

Allison Shelley

April 03, 2016


CHICAGO — Cardiovascular disease is the number one killer of women in the United States, but according to a Women's Heart Alliance report, many are embarrassed by a potential diagnosis because of the fear that people will think they aren't eating right or exercising.

"This is a myth we need to bust," lead researcher C. Noel Bairey Merz, MD, from the Cedars-Sinai Heart Institute in Los Angeles, told heartwire from Medscape. "Women are more likely to be told to lose weight than to check their blood pressure, yet existing risk factor scores do not even include weight," she pointed out.

In fact, nearly half the 1011 women who responded to a survey conducted by Dr Merz and her team, which will be presented at the American College of Cardiology 2016 Scientific Sessions, reported that it is somewhat common to cancel or postpone a doctor's appointment to give themselves more time to lose weight.

"Women are blaming themselves and then not necessarily being screened," Dr Merz said. "Women are objectified in our culture and valued for their appearance. Unfortunately, this carries over into healthcare. A woman with a healthy body mass index may not look like the images we see of thin models. She may have some cushion on her and she will likely live longer, yet her physician may focus on her weight — a crude and not necessarily accurate marker of nutrition and exercise."

The nationwide online survey took 15 minutes to complete, and internet access was provided to those who needed it. The researchers conducted their fieldwork using a knowledge panel that represented 97% of American households. Respondents were randomly selected using probability address-based sampling.

The majority of women reported having had a routine physical or wellness exam in the previous year, but few remember having their heart assessed, even though this is supposed to be part of a routine exam.

Table. Women's Heart Alliance Survey

Response Percent (n = 1011)
Had a routine physical or wellness exam in the previous year 70
Have one or more heart disease risk factors 74
Remember having a heart assessment 40
Have been told by a doctor that they have or are at risk for heart disease 16
Have somewhat commonly cancelled or postponed a doctor's appointment to lose weight 45
Have avoided seeing the doctor until they quit smoking 35


The researchers acknowledge that their results are limited by self-report. "This is a very representative sample, however, that crosses ethnicities and socioeconomic groups," Dr Merz pointed out.

The majority of women who die suddenly of coronary heart disease have no previous symptoms, according to the Centers for Disease Control and Prevention (CDC).

High blood pressure, elevated levels of low-density-lipoprotein cholesterol, and smoking are key risk factors, and the CDC estimates that about half of Americans have at least one of these three red flags.

"These are the risk factors we should be focusing on," Dr Merz said. "We found that women are stigmatized and women's healthcare still tends to focus on bikini medicine of pelvic, pap, and mammogram."

This survey was funded by the National Heart, Lung and Blood Institutes; the National Institute on Aging; the National Center for Research Resources; and by grants from the Gustavus and Louis Pfeiffer Research Foundation, The Ladies Hospital Aid Society of Western Pennsylvania, QMED, and Cedars-Sinai Medical Center. Dr Merz has disclosed no relevant financial relationships.

Follow Allison Shelley on Twitter @allishelley

American College of Cardiology (ACC) 2016 Scientific Sessions. Special Topics Intensive Session 54. Presented April 3, 2016.


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