Despite advances in cardiovascular medicine, women continue to face stark disparities in the diagnosis, treatment, and outcomes of heart disease. Research shows that women experiencing heart attack symptoms are more likely than men to be misdiagnosed or sent home without appropriate testing. They are also less likely to receive life-saving interventions like angioplasty or bypass surgery. As a result, women have higher mortality rates and poorer long-term outcomes.
The causes of this gender gap are well-documented: historical exclusion from clinical research, under-recognition of symptoms that present differently in women, and unconscious bias in medical settings. While public awareness of these issues has grown, awareness alone is not enough. Closing the gender gap in cardiovascular care will require systemic change across the health care ecosystem.
From updating clinical guidelines to advancing policy and strengthening provider training, real progress is possible if we act together.
Why the Gender Gap in Heart Health Still Exists
For years, cardiovascular disease was seen as a “man’s disease.” Research, training, and treatment protocols largely centered on male patients, and women’s symptoms were considered “atypical” rather than different and equally important. Although we now know that heart disease is the leading cause of death for women in the United States, the legacy of this gender bias still shapes the care women receive today.
Women are often underdiagnosed because their symptoms can differ from the “classic” signs of a heart attack, like chest pain. While chest pain remains the most common symptom for both men and women, women are more likely than men to also report additional or atypical symptoms, such as:
- Unexplained fatigue
- Shortness of breath
- Nausea or vomiting
- Jaw, neck, or back pain
- Lightheadedness
- Pain in one or both arms
When these symptoms are dismissed as anxiety, indigestion, or stress, diagnosis is delayed, sometimes fatally. However, these gaps are not just about individual cases. They are rooted in outdated systems that fail to account for how heart disease affects women.
So what can we do to close the gap?
1. Update and Apply Clinical Guidelines That Reflect Women’s Experiences
Clinical guidelines play a powerful role in shaping how heart disease is diagnosed and treated, yet many of these guidelines were developed based on research conducted primarily on men. Although some progress has been made, such as the development of women-specific guidelines by the American Heart Association, many providers still rely on outdated, one-size-fits-all approaches that do not account for sex-based differences.
To address this, updated guidelines must be adopted and applied more consistently across health systems. This includes:
- Training providers to recognize the full spectrum of heart disease symptoms in women
- Using diagnostic tools that are validated for women
- Implementing decision-making pathways that account for sex-specific risks
When providers are trained to apply guidelines appropriately, outcomes improve. Studies have shown that guideline-based care is associated with lower mortality and better recovery, particularly among historically underserved populations.
2. Strengthen Training and Education for Healthcare Providers
One of the biggest barriers to equitable care is a lack of awareness and training. Many medical professionals are still not taught to recognize the unique ways cardiovascular disease presents in women, or how implicit bias can influence their decisions.
Improving medical education is essential. Curricula should include robust training on:
- Sex and gender differences in cardiovascular disease
- Diagnostic approaches tailored to women’s symptoms
- Strategies to identify and address bias in clinical settings
Hospitals can also implement accountability systems. These might include equity-focused clinical audits, ongoing professional development, or mandatory bias training for emergency room staff, where heart disease is often first misdiagnosed.
Better training not only improves individual care but also shifts institutional culture toward greater equity and patient-centered practice.
3. Advance Policy Solutions That Prioritize Equity
Policy is a powerful lever for change. Legislative action and federal agency oversight can help drive better representation in research, accountability in clinical settings, and transparency in health outcomes.
Examples of policy priorities that support women’s cardiovascular health include:
- Requiring the inclusion of women in federally funded clinical trials
- Mandating sex-disaggregated data reporting for cardiovascular outcomes
- Funding research on sex-specific diagnostics and treatments
- Supporting public health initiatives focused on women’s heart health
Policymakers can also incentivize hospitals and academic centers to prioritize gender equity by linking it to funding or accreditation standards. When policy mandates change, institutions must follow, and that ripple effect can shift the entire healthcare landscape.
4. Support Advocacy and Community-Led Efforts
Finally, advocacy plays a critical role in driving both awareness and systemic reform. WomenHeart’s Treat Me Right campaign, for example, calls attention to the lived experiences of women who were dismissed or misdiagnosed, and it pushes for improvements in provider training and public policy.
When women share their stories, especially those from historically underserved communities, they help humanize the data and spotlight where systems are falling short. Advocacy organizations can also offer training, tools, and support to help women become stronger advocates for their own care.
Empowering patients is not a substitute for systemic reform, but it is a crucial part of the solution.
Moving Toward a More Equitable Future
The gender gap in heart health is not inevitable. It is the result of decades of systemic bias, and that means it can be changed with collective action.
By updating clinical guidelines, improving provider education, advancing policy reform, and supporting patient advocacy, we can build a future where all women receive the timely, accurate, and life-saving care they deserve.
WomenHeart remains committed to leading this charge through education, community, and a national voice for women living with heart disease. The time for action is now.
