Kearney, a leading management consulting firm, has released a comprehensive report titled  "Cardiovascular Health Inequity for Women in the Asia Pacific region," which sheds light on  significant disparities in women's cardiovascular care. This report is grounded in peer-reviewed  literature and evidence-based research. 

Cardiovascular disease (CVD) is the leading cause of death for women both in the Asia-Pacific  region and globally. The report delves into inequities in research and development, education,  access to care, treatment outcomes, and investment, and offers strategic recommendations for  addressing these issues. 

A staggering 80 percent of CVD cases could be prevented through the adoption of appropriate  lifestyle modifications, underscoring the immense potential for prevention. 

Dr. Stephanie Allen, Partner at Kearney and report author says: "Addressing cardiovascular health  inequities for women in Asia Pacific means confronting systemic gaps that have been neglected for  too long. These include the underrepresentation of women in clinical research, a lack of gender specific education in medical training, and insufficient investment in women's health technologies. It  is crucial to redesign care pathways for women and reduce barriers to treatment. This requires collaboration and action from all stakeholders across every stage of healthcare delivery to address  the women’s health gap and improve outcomes for everyone.” 

The Stark Reality of Cardiovascular Disease (CVD) in Women

Cardiovascular disease is the leading cause of death for women, not only in the Asia-Pacific region but globally. According to the report, 60% of the 18.6 million CVD-related deaths worldwide occurred in Asia in 2019. This trend is expected to worsen, with the region’s cardiovascular mortality rates projected to double by 2050. Despite the alarming numbers, the report reveals that 80% of CVD cases could be prevented through lifestyle changes, highlighting the immense potential for early intervention and prevention.

Yet, systemic barriers, rooted in gender inequity, prevent effective care for women, putting them at greater risk of misdiagnosis, delayed treatment, and adverse outcomes. These inequities permeate various aspects of healthcare, from research and education to treatment outcomes and investment.

Underrepresentation in Clinical Research

A critical factor driving the inequities is the underrepresentation of women in cardiovascular research and clinical trials. Historically, clinical trials have predominantly involved male participants, particularly Caucasian men, leading to a lack of gender-specific data. Women, especially those from ethnic and racial minorities, are often left out, resulting in less evidence-based clinical care tailored to their unique health needs.

This lack of representation is particularly evident in key cardiovascular studies, including those on coronary artery disease, heart failure with reduced ejection fraction, and arrhythmias. The European Society of Cardiology and other global bodies have called for greater investment in women-focused cardiovascular research, but progress remains slow.

Educational Gaps and Misdiagnosis

Education plays a pivotal role in shaping healthcare delivery, yet women’s cardiovascular health is largely overlooked in medical curricula. A review of Australian medical schools, for example, found that while 84% of them offer courses on women’s health, the content is largely limited to obstetrics and gynecology. Little emphasis is placed on non-reproductive health issues, including cardiovascular disease.

The consequences of this educational gap are dire. Women often present with non-traditional symptoms of heart disease, such as gastrointestinal issues, prolonged fatigue, or sleep disturbances, rather than the typical chest pain and shortness of breath. If healthcare professionals are not routinely trained in recognizing gender-specific symptoms, they risk underdiagnosing or misdiagnosing female patients, leading to poorer outcomes.

Delayed Treatment and Adverse Outcomes

The report also highlights the significant delays women experience in receiving cardiovascular treatment. On average, women take 30 minutes longer than men to reach a hospital after the onset of heart attack symptoms. This delay, coupled with a tendency toward underdiagnosis, contributes to a higher risk of death and complications. In fact, women are twice as likely to die from a heart attack as men in the Asia-Pacific region.

Even after diagnosis, women face barriers in accessing effective treatment. They are less likely to receive aggressive interventions such as stents or heart surgery and are more likely to experience adverse reactions to cardiovascular drugs. These disparities result in higher rates of in-hospital mortality, repeat heart attacks, strokes, and major bleeding in women.

The Investment Gap: Women’s Health Underfunded

The report underscores the stark underinvestment in women’s health, particularly in cardiovascular disease. Despite the potential of digital technologies to address health inequities, women’s health-focused start-ups receive only 3% of global digital health funding. This lack of financial support exacerbates the challenges women face in accessing high-quality care.

Digital tools, such as the My Anna Health platform and the AI-based Cardio Explorer, have demonstrated promise in improving women’s cardiovascular outcomes. However, the gender gap in access to technology remains a major barrier. In Asia, 197 million fewer women than men own mobile phones, limiting their ability to benefit from digital health innovations.

Strategic Solutions: Closing the Gender Gap in Cardiovascular Health

Addressing these inequities requires a multifaceted approach, involving collaboration between governments, healthcare providers, industry stakeholders, and patient advocacy groups. The report outlines several key recommendations for creating positive change in women’s cardiovascular health outcomes:

1. Public Awareness Campaigns: Governments, patient advocacy groups, and industry bodies should work together to raise awareness about the unique risks of cardiovascular disease in women. Public health campaigns should emphasize prevention and highlight the differences in how CVD manifests in women.

2. Overhauling Medical Education: Medical schools must integrate gender-specific information into their curricula, ensuring that future healthcare professionals are trained to recognize and address the unique cardiovascular health needs of women. This includes mandatory instruction on the differences in disease presentation and treatment between men and women.

3. Doubling Down on Research and Development: More research is needed to understand the sex-specific factors that contribute to cardiovascular disease in women. This includes increasing the representation of women, particularly those from ethnic and racial minorities, in clinical trials and ensuring that research findings are applied to improve women’s healthcare.

4. Increasing Access to Care: Policymakers and healthcare providers must work to remove the barriers that prevent women from accessing timely and effective cardiovascular care. This includes addressing socioeconomic factors, such as distance from healthcare facilities and financial constraints, which disproportionately affect women in rural and low-income areas.

5. Accelerating Investment in Women’s Health: There is a clear opportunity for increased investment in women’s cardiovascular health. Start-ups and innovative companies focused on women’s health should receive greater financial support to develop technologies that address the unique challenges women face in managing cardiovascular disease.

6. Building Integrated Care Pathways: Successful models of collaboration between healthcare professionals, public-private partnerships, and local communities should be scaled across the region. Integrated care pathways that consider women’s unique health needs can improve outcomes and ensure that women receive the right care at the right time.

Conclusion: The Path Forward

The inequities in cardiovascular health for women in the Asia-Pacific region are deeply rooted and multifaceted, but they are not insurmountable. By addressing the systemic barriers that prevent women from receiving high-quality care, stakeholders across the healthcare spectrum can improve outcomes for millions of women across the region.

The Kearney report calls for bold, coordinated action to close the gender health gap, urging policymakers, healthcare providers, and investors to prioritize women’s cardiovascular health. As Dr. Stephanie Allen, one of the report’s authors, aptly states, “Addressing cardiovascular health inequities for women in Asia-Pacific means confronting systemic gaps that have been neglected for too long. It is crucial to redesign care pathways for women and reduce barriers to treatment.”

By implementing the strategic recommendations outlined in the report, the Asia-Pacific region has the potential to significantly reduce the burden of cardiovascular disease in women and improve health outcomes for all.