Heart attacks are often missed in women. this is

Jennifer Dungan

Photo: Jennifer Dungan
Opinion more

Credit: University of Florida

When cardiac diagnostic tests were first created, scientists at the time did not consider that no two bodies are the same, especially between the sexes.

According to an associate professor at the University of Florida College of Nursing, Jennifer DunganMany current symptom profiles and laboratory tests for heart disease do not accurately reflect the known differences in heart disease in women. This oversight has increased health care equity gaps.

“Because of this disparity, women are more likely than men to report symptoms of heart disease that appear outside the norm, experience delayed treatment for heart disease and even undiagnosed heart attacks,” Dungan said. “For reasons that remain uncertain, women can experience heart disease differently than men. This can lead to inequality among women which needs to be addressed.”

The heart researchers believe that some of these differences in symptoms and outcomes may be due to genetic differences between men and women, Dungan said. You’ve identified a specific gene that you think might be responsible, called RAP1GAP2.

“RAP1GAP2 is a strong candidate for sex-related effects on heart disease outcomes in women,” Dungan said. Certain DNA markers in this gene are thought to manage the activity of platelets, the colorless blood cells that help blood clot. This also represents the risk of a heart attack. The overactive gene can cause too many platelets to respond to clot, which can block the flow of blood and oxygen to the heart muscle and lead to a heart attack.”

Because RAP1GAP2 was not associated with poor heart outcomes among the men in her team’s study, she thinks this gene may work differently in women. Her team included faculty from the UF Schools of Medicine, Pharmacy, Public Health, and Health Professions. Their findings were recently published in American Heart Journal Plus.

Little is known about these differences between races and races. Black women and some Hispanic women are at higher risk of bad heart disease, due to many factors that Dungan thinks may include genes.

Unfortunately, the traditional ways in which racial and ethnic groups are studied tend to produce irrelevant results, Dungan said.

“The goal is not to find biological differences between groups of people. Our goal instead is to find the genetic markers most associated with heart disease for all women.” To do that, we need to look at genetic diversity within women as well.

To discover how the gene affects heart disease risk among women of different backgrounds, Dungan’s latest project, supported by a two-year grant from the National Institute on Aging, a division of the National Institutes of Health, aims to find the specific RAP1GAP2 gene. Signs that are closely related to symptoms of disease, heart attack, and death in women of different racial and ethnic groups.

Using health data from 17,000 postmenopausal women, Dungan and her team will use statistical methods of genetics to analyze whether there is an association between certain DNA markers on RAP1GAP2 and heart disease. Her team will also use genetic ancestry markers instead of arbitrary racial categories to account for the natural diversity in our genetic code. According to Dungan, this will confirm that her team is finding genetic markers that reflect all heart disease risks in women, not just certain groups.

“At the end of the study, if the RAP1GAP2 genetic marker accurately reflects heart symptoms in women and predicts their likelihood of having a heart attack, stroke, or death in the future, these genetic markers can help us be more confident in their diagnosis and predicting the future,” he said. “Having more accurate biomarkers for women would save lives and improve health equity for all women.”

The research presented in this publication was supported by the National Institute on Aging of the National Institutes of Health under award number R21AG077715. The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


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