American Heart Association Special Report
- Ten-year trends indicate awareness remains steady in older women but points to critical gaps among younger women and women of color, prompting calls for coordinated efforts to do more.
- Women’s awareness that heart disease is their leading cause of death declined markedly in the last decade, from 65% of women being aware in 2009 to 44% being aware in 2019.
- The decline in awareness was observed among all racial, ethnic and age groups except women ages 65 and older.
- Most surprising, researchers noted that women with high blood pressure, a leading cause of heart disease, were 30% less aware than women overall that heart disease is the leading cause of death among women. Blood pressure history was asked about only in 2019.
Embargoed until 4 a.m. CT / 5 a.m. ET Monday, September 21, 2020
DALLAS, Sept. 21, 2020 — Women’s awareness that heart disease is their leading cause of death has declined significantly, from 65% of women being aware in 2009 to 44% being aware in 2019, according to a new American Heart Association Special Report, “Ten-Year Differences in Women’s Awareness Related to Coronary Heart Disease: Results of the 2019 American Heart Association National Survey,” published today in the Association’s flagship journal Circulation. The decline in awareness was observed among all racial, ethnic and age groups except women ages 65 and older.
“Looking across survey years, in 2009, 2012 and 2019, we found that women who were younger vs. older, and non-Hispanic black, Hispanic or Asian vs. white had lower awareness that heart disease was the leading cause of death,” said Mary Cushman, M.D., M.Sc., FAHA, professor of medicine at the Larner College of Medicine at the University of Vermont, and chair of the writing group for the statement.
Cushman also called attention to the need identified in this study to increase awareness efforts among women at various socioeconomic levels.
“Women with lower educational attainment and lower household income, as markers of socioeconomic status, also had lower awareness. These all point to groups that could benefit most from programs to raise awareness, i.e., lower income women, less educated women, nonwhite women and younger women. To reach these women, we need to innovate ways to meet them where they are so they can develop healthier lifestyle patterns to support optimal heart health 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% 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 (adjusted for factors such as education level and income) were among Hispanic women (86% decline), Black women (67% decline) and women ages 25-34 years old (81% decline).
- Women were more likely in 2019 than a decade ago to erroneously believe cancer is the leading cause of death:
- 16.5% thought breast cancer was the leading cause in 2019 compared to 7.9% in 2009; this belief was most common among younger women (ages 25-34).
- 40.1% of women surveyed identified cancer (all types) as the leading cause of death for women in 2019 compared to 26.5% in 2009.
- Awareness of heart attack symptoms declined among all women. Only 52% of women reported that chest pain was a symptom, and 38% reported pain that spreads to shoulders, neck or arms was a symptom. 28% reported shortness of breath as a symptom.
- The news about women’s awareness of what to do if they are having heart attack symptoms was mixed. Knowledge that they need to call 9-1-1 was up from 47% in 2009 to 54% in 2019 but knowing they should take an aspirin was down from 23% to 14% over the 10-year period.
“Alarms should be sounded to address this highly concerning trend among younger women and women of color,” said Cushman. “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 number one priority – we should be as close as possible to 100% 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% to 56% between 1997 and 2012. Awareness of heart attack symptoms also increased from 1997 to 2012. Considerable progress has been made by the Association and Go Red for Women® over the last two decades to raise awareness and reach tens of millions of women and health care professionals. Women inspired at the inception of the Association’s Go Red for Women movement in 2004, particularly women in their 30-40s at the time, have championed women’s health for more than 17 years and are still the most likely to recognize heart disease and stroke as their greatest health threats based on the 2019 survey findings.
Preventing heart disease and stroke in women remains a priority for the Association. The Association’s signature women’s initiative, Go Red for Women, is committed to meeting the comprehensive health needs of women at every life stage.
“For nearly 20 years, the Association and Go Red for Women have been at the forefront of emerging science,” said Cushman. “This survey gives us the data we need to better inform the women in our lives to take charge of their health. The movement is poised to evolve to reach younger generations of women in new, innovative ways.”
Go Red for Women formed in 2004 and expanded into a worldwide movement dedicated to removing the barriers women face to achieving good health and well-being. The Association’s work led to the first guidelines about women and cardiovascular disease for medical professionals. In 2004, the Association expanded its focus on female-specific clinical recommendations and sponsored the evidence-based guidelines for the prevention of cardiovascular disease in women; these guidelines were updated in 2007, and the latest update was released in 2011. Women-specific stroke guidelines were published in 2014. Of late, the Association published a statement on the connection between cardiovascular health and maternal health in May 2020.
The Association supports comprehensive health solutions designed to improve awareness among women that cardiovascular disease is a woman’s greatest health threat:
- In 2019, the movement launched Research Goes RedTM in conjunction with Verily’s Project Baseline placing women in the driver’s seat to accelerate scientific discovery and ensuring equitable representation in clinical trials. Clinical trials have not been inclusive of women historically, especially women of color, hindering the progress of understanding women’s specific risks, symptoms, diagnosis and treatment. Research Goes Red calls on women across the U.S. to contribute to health research. The initiative aims to develop the world’s most engaged research platform for women.
- The Go Red for Women Strategically Focused Research Network (SFRN) brings together researchers from top institutions to address issues unique to women’s health. All centers train fellows and collaborate with others in the SFRN to advance the mission and impact of the Association.
- In an effort to expand its reach to our Hispanic-dominant communities, the Go Red for Women site was fully translated in Spanish in November 2019.
The 2019 survey data informs and drives next steps for the American Heart Association and Go Red for Women as they continue efforts to engage, inspire and empower every woman, at every stage of life.
Co-authors of the survey study with Dr. Cushman are Christina M. Shay, Ph.D., FAHA; Virginia J. Howard, Ph.D., FAHA; Monik C. Jiménez, Sc.D., FAHA; Jenifer Lewey, M.D., M.P.H.; Jean C. McSweeney, Ph.D., R.N., FAHA; L. Kristin Newby, M.D., M.H.S., FAHA; Ram Poudel, M.S., M.A.; Harmony R. Reynolds, M.D., FAHA; Kathryn M. Rexrode, M.D., M.P.H., FAHA; Mario Sims, Ph.D., M.S., FAHA; and Lori J. Mosca, M.D., M.P.H., Ph.D., FAHA. Author disclosures are in the manuscript.
- Available multimedia is on right column of release link - https://newsroom.heart.org/news/heart-disease-awareness-decline-spotlights-urgency-to-reach-younger-women-and-women-of-color?preview=13e710499a39f9944eedb8d059324238
- After 4 a.m. CT/ 5 a.m. ET, Monday, Sept. 21, view the manuscript online.
- Circulation journal: Fifteen-Year Trends in Awareness of Heart Disease in Women (2012)
- Circulation: Cardiovascular Quality & Outcomes journal: Twelve-Year Follow-Up of American Women’s Awareness of Cardiovascular Disease Risk and Barriers to Heart Health (2009)
- Follow AHA/ASA news on Twitter @HeartNews
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About the American Heart Association
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