Studies Reveal Gender Gap in Heart Care

Younger women less likely than men to be warned of risk, get same treatments or survive after heart attack

Monday, October 26, 2015

MONDAY, Oct. 26, 2015 (HealthDay News) -- New research suggests that doctors don't warn younger women when they're at risk for heart disease as often as they warn men.

And once younger women suffer a common kind of heart attack, they are less likely to get a common treatment and more likely to die in the hospital.

The findings were reported in two separate studies in the Oct. 26 issue of the Journal of the American College of Cardiology.

The disparities between the genders were significant. According to the analysis of 1.4 million heart attack cases, 4.5 percent of women under 60 died in the hospital, compared to 3 percent of comparable men. The death rates for both genders actually went up from 2004-2011.

The findings challenge "the mistaken belief that women are not at risk for heart attack and that it is 'a man's disease.' Just because a woman is relatively young, she should not assume that worrisome symptoms must be something else," said Dr. Deepak Bhatt, executive director of interventional cardiovascular programs at Brigham and Women's Hospital in Boston. He is co-author of the study into treatments for heart attack.

In the other study, researchers led by Erica Leifheit-Limson, an associate research scientist in chronic disease epidemiology at the Yale School of Public Health, looked at the medical records of more than 2,300 women and 1,100 men from the United States and Spain -- aged 18 to 55 -- who'd had a heart attack. The researchers wanted to know if physicians had previously told those with risk factors like diabetes and obesity that they face a higher risk of heart disease.

Only about half of the U.S. men and women said they'd gotten a heads-up from their physicians about their risk and ways to reduce it. Women were 11 percent less likely than men to be told they're at risk, and 16 percent less likely to report that their doctor discussed ways to reduce their risk.

In the treatment study, researchers looked at patients who suffered a common kind of heart attack known as ST-segment elevation myocardial infarction. Women were less likely to receive a blood vessel-opening treatment known as angioplasty via stent. By 2011, the rate of this treatment had grown to 84 percent in men but only 77 percent in women.

Differences between men and women remained even after the researchers adjusted their statistics so they wouldn't be thrown off by various factors.

What's going on? "Younger patients presenting with a heart attack can be particularly challenging, as the diagnosis is not always immediately considered," study co-author Bhatt said. "This may be even more true in younger women versus younger men."

The findings are important because there are still gender differences in how heart disease is diagnosed and treated, said Dr. C. Noel Bairey Merz, director of the Barbra Streisand Women's Heart Center and Preventive and Rehabilitative Cardiac Center at Cedars-Sinai Medical Center's Heart Institute in Los Angeles. She co-wrote a commentary accompanying the study.

In some cases, she said, physicians don't launch the best treatment in younger women with cardiac problems. This happens because "their test results do not look like men's," and therefore the doctors are uncertain about their diagnosis, she said. Disparities in cardiac disease also exist, she said, because of differences in how treatment affects women.

How can the findings of these studies be useful? Bairey Merz said they could be a force toward more use of treatment guidelines and more advocacy for cardiac research that looks at both genders. The gender gap narrows and women's lives are saved, she said, when physicians are reminded to follow guidelines.

Officials should also enforce existing policies that require women to be included in research instead of men only, she added.

SOURCES: Deepak Bhatt, M.D., M.P.H., executive director, interventional cardiovascular programs, Brigham and Women's Hospital, and professor, medicine, Harvard Medical School, Boston, Mass.; C. Noel Bairey Merz, M.D., director, Barbra Streisand Women's Heart Center and Preventive and Rehabilitative Cardiac Center, Women's Guild Chair in Women's Health and professor, medicine, Health Institute, Cedars-Sinai Medical Center, Los Angeles, Calif.; Oct. 26, 2015, Journal of the American College of Cardiology

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