Women experience worse post-heart attack treatment than men

Women experience worse post-heart attack treatment than men

heart

Women living in Australia undergo worse medical treatment than men for common heart attacks according to a study undertaken by researchers from the University of Sydney.

The study has found that women diagnosed with the condition unstable angina, or a common type of heart attack, received “less evidence-based treatment” than men, either immediately or in the long term.

The study, published in the Medical Journal of Australia, looked at a database of 7,783 patients from forty-three hospitals around the country who were diagnosed between 2009 and 2018 with unstable angina or heart attacks medically identified as non-ST elevation myocardial infarctions (non-STEMIs).

The lead researcher David Brieger, a physician and professor of cardiology at the University of Sydney, told The Guardian that the report suggests “physician biases” in Australia’s medical care.

Brieger said the treatment for these conditions were vastly dissimilar between men and women “every step of the way”.

“Despite the way we think we’re practising, we are still innately conservative and under-treating women for whatever reason,” he said. 

“I think we have to be aware of that and consciously address it.”

Roughly 31 percent of the patients in the study were female.

Non-ST elevation myocardial infarctions are considered severe diagnosis, though not as damaging as ST-elevation myocardial infarctions, which women are half as likely to get proper hospital treatment for.

Patients with non-STEMIs are often advised to undergo a procedure called an angiogram —  an imaging technique that identifies blockages in the patients’ coronary arteries.

David Brieger’s study revealed that a smaller proportion of women than men were given angiograms, and that the women who did tended to receive them later.

“We’re not sure whether that reflects the fact that they presented to hospital later, or the decision to do the angiogram was delayed in some way,” Brieger said.

Studies have shown that women who suffer heart attacks may experience different symptoms to men, such as sweating, nausea, and fatigue. Women are also much likelier to have symptoms of their cardiac events misdiagnosed

Research in the past has indicated existing discrepancies between men and women when it comes to long-term medical care

“Once someone has come in with a coronary event they should all be discharged on evidence-based treatments,” Brieger said.

His team at the University of Sydney found that women were less likely to be given a range of common therapies, such as beta blockers, aspirin, anti-platelet drugs, and statins — medication which reduces levels of cholesterol in the blood.

Brieger said the angiograms his team studied showed that women were likelier to have less significant obstructions of their coronary arteries than men, which indicates “… that they’re less likely to require stents and require a bypass. But what we found is that that also drove a lower likelihood of receiving medical therapies.” 

“To our surprise, even if they did have blockages, they still got less treatment,” Brieger continued.

“Even if we don’t identify tight blockages in the arteries, we still know that women that have these [heart attacks] are at an increased likelihood of having further events.”

“Putting them on these medications will prevent these further events from happening.”

Additionally, women were less likely to obtain cardiac rehabilitation, “which is also very important in restoring them back to pre-event functional capacity and ensuring better longer-term outcomes,” Brieger said. 

Last October, a study published in Oxford University’s Medical Journal of Cardiology found that young women could be more likely to die than men in the decade following a heart attack.

The study found that only 400 of 2100 heart attack patients treated in two hospitals in Boston were women. However, over the long-term, the female patients were more likely to die than the male patients.

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