October 17, 2008

Women With Heart Symptoms Face Gender Bias

Coronary heart disease symptoms in women presented in the context of a stressful event are identified as psychogenic, or "in her head," U.S. researchers say.

Eighty-seven internists and 143 family physicians evaluated a vignette of a 47-year-old male or a 56-year-old female -- by age at equal risk for cardiac heart disease. Half the vignettes included sentences indicating a life stressor and the appearance of anxiety.

When stress was included, 15 percent of the women received a coronary heart disease or coronary heart disease assessment versus 56 percent of the men. Cardiologist referrals were 30 percent for women versus 62 percent for men. No evidence of a bias was observed when cardiac symptoms were presented without the stress.

"For men, cardiac symptoms drive the interpretation of accompanying symptoms so that anxiety or stress is perceived (rightly so) as a risk factor," study leader Gabrielle R. Chiaramonte of the Weill Medical College of Cornell University and New York-Presbyterian Hospital says in a statement.

For women, however, the presence of anxiety or stress "appears to preclude a coronary heart disease assessment."

The study results were presented at the Transcatheter Cardiovascular Therapeutics scientific symposium in Washington.