Heart disease is killing more women in Pakistan than previously understood, with female patients experiencing higher mortality rates, more severe symptoms and delayed diagnoses compared to men, according to a landmark hospital-based study published this week.

The paper, ‘Burden of cardiovascular disease in women: data from Pakistan’s largest cardiac hospital network,’ was released in npj Women’s Health this month and analyzed data from over 14,800 patients treated at the National Institute of Cardiovascular Diseases (NICVD). It found that women with heart conditions are more likely to die than men, despite presenting at a younger age in some cases and with more complex symptoms.

“Women are diagnosed at a later stage, have delayed surgical referrals, and have poorer post-operative outcomes than males,” the researchers wrote. “There is a scarcity of data from South Asia due to underrepresentation of women in studies, which limits the development of evidence-based guidelines.”