Women heart patients under-treated, twice as much as men

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Australian study shows quality of treatment women receive is not the same as that of men

Women with heart conditions are under-treated, a new study has revealed.

Published in today’s Medical Journal of Australia, the study of 2898 patients (2183 men, 715 women) found that six months after hospital discharge, death rates and serious adverse cardiovascular events in women were more than double the rates seen in men.

Sex differences in the management and outcomes of patients with acute coronary syndromes such as ST-Elevation Myocardial Infarction (STEMI) have been reported in  medical literature. But most studies fail to adjust for ‘confounding’ factors that can affect the accuracy of findings.

“We focused on patients with ST-Elevation Myocardial Infarction because the clinical presentation and diagnosis of this condition is fairly consistent, and patients should receive a standardised management plan,” said the University of Sydney’s Professor Clara Chow who is a cardiologist at Westmead hospital. She is the study’s senior author. A STEMI or ST-elevation myocardial infarction (heart attack) happens when a fatty deposit on an arterial wall causes a sudden and complete blockage of blood to the heart, starving it of oxygen and causing damage to the heart muscle.

In India, it is empirical wisdom that women tend to get medical care later than men, However data specifically about women heart patients and the quality of treatment they get is hard to come by

In India, it is empirical wisdom that women tend to get medical care later than men, However data specifically about women heart patients and the quality of treatment they get is hard to come by.

The reasons for the under-treatment and management of women compared to men in Australian hospitals aren’t clear. “It might be due to poor awareness that women with STEMI are generally at higher risk, or by a preference for subjectively assessing risk rather than applying more reliable, objective risk prediction tools. Whatever the cause, these differences aren’t justified. We need to do more research to discover why women suffering serious heart attacks are being under-investigated by health services and urgently identify ways to redress the disparity in treatment and health outcomes,” she added.

Professor David Brieger, co-author of the study and leader of the CONCORDANCE registry from which the findings were extracted, agrees: “While we have long recognised that older patients and those with other complicating illnesses are less likely to receive evidence based treatment, this study will prompt us to refocus our attention on women with STEMI.”