Experts issue health alert as fewer women survive for 30 days following a heart attack

The number of women surviving heart attacks is falling in Scotland – and the decline is faster than for men, figures reveal.

The statistics, released by Public Health Scotland, showed fewer females were alive 30 days after the cardiac emergency last year than the previous 12 months.

A total of 2,336 women had survived at that point in 2021-22, compared with 2,426 a year earlier.

The fall, of 1.4% and involving almost 100 additional deaths, was described as “dismal” by health campaigners. Cardiologists claimed it might be as a result of the increased pressure on the NHS caused by Covid-19. The survival rate is also lower than it was immediately before the pandemic.

The figures follow a report by the European Society of Cardiology last month that said women were more than twice as likely to die after a heart attack than men.

Survival for men in Scotland is also falling but not as markedly as in women, the Scottish Government health findings said.

Improving heart health is one of the top priorities of Scotland’s new women’s health champion, Professor Anna Glasier OBE.

Heart specialist Dr Anna Barton, cardiology registrar and British Heart Foundation PhD student at Edinburgh University, said: “This fall in women surviving heart attacks is not what we would want to see. I will be ­watching closely to see what comes next year and the following one. The gap between men and women had been closing, which is good. Increased NHS pressure is likely to be a factor in the fall in survival for women and men.”

Barton said it was also ­possible that people were either not presenting with symptoms or delaying going to hospital, fearing they would be busy.

She added: “I would emphasise the importance in coming forward for assessment of any symptoms of concern. The NHS is very much equipped to assess and treat both heart attacks and other causes of chest pain.”

She said that, while it was important to remind women they can experience symptoms not typical of heart attacks, new evidence shows classic signs, including central chest pain, are experienced equally by men and women.

“We do not want women to always expect ‘atypical’ symptoms,” said Barton. “In fact, we would now recommend against using this term, which may contribute to the unhelpful assumption that a woman presenting with central chest discomfort couldn’t possibly be having a heart attack as women don’t experience the typical symptoms. This is clearly wrong.

“However, it is more ­common for women to have accompanying symptoms like dizziness, be short of breath and have palpitations at the onset of their heart attack.”

Specialist: Diagnosis of women’s heart condition is too slow

Heart failure is more often missed among women, according to Professor John Cleland, of Glasgow University’s School of Cardiovascular and Metabolic Health. He said many patients on diuretics for puffy ankles and high blood pressure were suffering heart failure, with women more likely to be given the medication and go undiagnosed.

He added: “For patients with heart failure, lifestyle advice, medicines and devices can improve symptoms, reduce morbidity and prolong life, but this requires someone to recognise and diagnose the condition.”

Heart campaigner and patient Mary Galbraith said women’s survival rates had been poorer than men’s – and are now getting worse.

She said: “Women are going from a position of poorer survival to worse still. It is dismal news for women that the gap in survival could be widening. More awareness and publicity campaigns are desperately needed. We cannot be losing mothers, daughters, sisters and good friends because of a deficit in awareness of what it takes to survive.”

Galbraith, a former deputy head teacher from Benbecula, survived a heart attack after being initially informed she was not ill. A paramedic who knew her from parents’ evenings overruled this and took her to hospital where the heart attack was diagnosed.

The type of heart attack Mary suffered, aged 39, was caused by a spontaneous coronary artery dissection, more commonly seen in younger women.

The British Heart Foundation said UK women die needlessly from heart attacks or fail to make as good a recovery because they do not receive the same care and treatment as men.

A Scottish study by Heart Research UK reveals that almost half of women were unaware their risk of coronary heart disease increases after the menopause.

A third aged 45-54 have never had their cholesterol checked and half of all women are unconcerned about heart disease risks.

Dr Pierpaolo Pellicori, cardiologist and clinical researcher at Glasgow University, said: “Heart disease is the leading cause of death, globally, for men and women. The survey suggests there is a need for putting additional efforts to inform women of risk factors.”

The Scottish Government said it was “committed to ensuring that everyone with heart disease has timely and equitable access to diagnosis, treatment and care”.

A spokesman added: “Since 2012-13, the percentage of women surviving 30 days after a first emergency admission for heart attack has increased from 88.4% to 90.4% in 2021-22. Over the same period, there was a narrowing of the gap in the survival between males and females from 5.6 to 2.8 percentage points.”