Indian women face disparities in the diagnosis, treatment, and prevention of cardiovascular illnesses. Despite the fact that both genders have a significant health problem, women receive less intensive therapy and are more likely to be underdiagnosed. This imbalance leads to delayed diagnosis and insufficient treatment, both of which have a negative influence on patient health.
As cardiovascular disease remains the leading cause of death among Indian women, surpassing breast and other cancers combined (Lancet, 2022). The incidence of coronary heart disease among Indian women ranges from 3% to 13%, increasing nearly 300% over the past two decades (Indian Heart Journal, 2020). From 1.1% in 2000 to 2.6% in 2015, the prevalence of heart failure in women has similarly increased dramatically (Global Burden of Disease Study, 2017).
Why does heart disease in women go undetected?
Many women are unaware of their heart disease risk, leading to late detection. Symptoms are often different from chest pain and may include fatigue, nausea, dizziness, or jaw pain. Nearly 45% of women aged 20 and older have cardiovascular disease, but many do not know (American Heart Association, 2024). Pregnancy-related conditions, like high blood pressure and diabetes, raise the risk but are rarely discussed. High blood pressure is especially dangerous, causing 51.9% of hypertension-related deaths in women (Go Red for Women, 2024).
Barriers to cardiac care
Gender disparity in cardiac care arises due to unawareness, late symptom recognition and biases within the healthcare system. Women often experience nonspecific symptoms such as fatigue, nausea, or jaw pain, leading to misdiagnosis or delayed treatment.
Biological and clinical differences : Women’s heart disease symptoms are different from men’s, which leads to underdiagnosis. Women may have jaw pain, nausea, exhaustion, or shortness of breath following a heart attack, but men typically describe chest pain. These mild indicators sometimes lead to poorer outcomes and delayed diagnosis.
Limited access to healthcare : In India, 80% of cardiologists work in urban areas, creating barriers for rural populations. Women in villages frequently travel 50–100 km for check-ups, a costly and time-consuming journey. As a result, treatment is usually sought at later, more serious stages of the disease.
Socio-cultural barriers : Traditional norms in India contribute to delayed cardiac care for women. Prioritising family responsibilities over personal health, many women postpone seeking medical attention. Additionally, the cardiovascular risk in female patients is underestimated due to the false belief that heart disease mostly affects men.
Healthcare system biases : Gender disparities in treatment further exacerbate inequities. Studies indicate that women are less likely to receive evidence-based therapies such as lipid-lowering medications, aspirin, or beta-blockers. Data from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP) reveal that women receive suboptimal cardiovascular care despite having similar clinical presentations.
Strategies to address disparities
Action is required from both women and the healthcare system to bridge this gap. The actions listed below can be beneficial:
1. Awareness raising – Heart disease is often perceived as a male issue, but it affects women as well. Public health campaigns should educate both women and healthcare providers about female-specific symptoms.
2. Regular screenings – Routine heart check-ups, particularly for women over 40, can aid in early detection. Serious consequences can be avoided by regular blood pressure, cholesterol, and blood sugar monitoring.
3. Healthcare provider training – Improved training is necessary for doctors and nurses to recognize heart disease symptoms in women and ensure equitable care.
4. Better access to care – Women in rural areas often face challenges in reaching specialists. Accessibility can be improved with telemedicine, mobile clinics, and community programs.
5. Affordable treatment – Government policies and insurance coverage should prioritise affordability, ensuring that low-income women have access to essential heart treatments.
Technology’s role in minimising the gender gap in cardiac care:
Telecardiology technology is improving heart care in rural areas. Heart scans in village clinics are made possible by portable ECG devices, with results promptly sent to urban cardiologists for diagnosis. AI-driven algorithms quickly analyse heart data, identifying potential risks. Diagnoses are delivered 90% faster than traditional methods, reducing the number of emergencies. By offering free and accessible screenings, technology helps ensure that women in remote areas receive essential heart care.
(The author, Arindam Sen, is a CEO & Director of Heartnet India.)
