Women losing out in heart care to men

By Ben Hirschler

STOCKHOLM (Reuters) – A perception that cardiovascular
illness is mostly a male problem has led to poorer treatment
for women with heart disease, leading doctors said on Sunday.

Professor Caroline Daly of Royal Brompton Hospital in
London told the European Society of Cardiology congress that
despite the fact that heart attacks and strokes kill a higher
percentage of women than men, the common perception that women
were less likely to suffer from heart disease remained.

She said women with chest pains were 20 percent less likely
to be referred for an exercise test, the first way of checking
for angina, and were 40 percent less likely to have an
angiograph, or x-ray, to determine the extent of any coronary
obstruction, she said.

A study of nearly 3,800 patients across Europe also found
that women with angina were less likely to get life-prolonging
heart drugs, such as aspirin and cholesterol-lowering pills.

“Women are under-investigated and under-treated, even
though their symptoms are worse and they have a worse
prognosis,” Daly told reporters.

Professor Ian Graham of the Adelaide and Meath Hospital in
Dublin said the idea that women were protected from heart
disease was an illusion. They simply contracted the condition
later than men — but once it set in it tended to kill them
faster.

Most women’s biggest fear is breast cancer. Yet heart
disease kills twice as many women as all cancers put together,
and is responsible for 55 percent of deaths in women compared
to 43 percent in men.

Daly said there were some encouraging signs that the bias
in care was starting to change but more needed to be done to
improve diagnosis and treatment in women.

A crucial element should be more research on how women
respond to heart treatments, doctors said.

The fact that women are under-represented in clinical
trials means cardiologists are often in the dark as to how
drugs may work differently in their bodies, due to hormones,
body weight and other biochemical factors.

Already known gender differences include the fact that
women are twice as likely as men to develop a persistent cough
if given ACE inhibitors, a commonly prescribed type of drug for
high blood pressure.