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Unequal Heart Attack Treatment for Women Causes Gap in Mortality Rate

In the United States, over 430,000 women have heart attacks annually, according to the Women’s Heart Foundation. 42 percent of these women are likely to die within a year after the attack, while only 24 percent of men die in this time period. But the United States is not alone.

Researchers from the University of Leeds and the Karolinska Institute in Sweden conducted a study of 180,368 Swedish heart attack patients over 10 years. During this study, they found that women are two times more likely than men to die within a year of suffering from the most dangerous type of heart attack, called a STEMI, which requires immediate treatment and occurs when a blood clot completely blocks a major artery.

These researchers guess that the difference in numbers can be attributed to differences in care for women and men, even though there are guidelines that prescribe equal treatment for both groups.

In their data for STEMI patients, the researchers found that women were 34 percent less likely than men to receive treatments such as bypass surgeries and stents, which would have cleared their blocked arteries. They also found that women were 24 percent less likely to be prescribed a medication called Statin, which helps prevent a second heart attack, and were 16 percent less likely to be prescribed aspirin, which assists in preventing blood clots.

All three of these methods are included in the suggested guidelines for heart attack treatment.

The study found that when women did receive these treatments, their mortality rate almost always decreased, bringing the number closer to that of male patients.

One of the co-authors of the study, Professor Chris Gale of the University of Leeds, wrote in other papers that part of the problem also lies in the fact that women are less likely than men to receive the same diagnostic tests for cardiovascular problems and heart attacks, which means that they are 50 percent more likely to be misdiagnosed.

“That then feeds the whole pathway of care,” Gale told the BBC. “If you missed the first, earliest opportunity for care – you’re much more likely to miss the next point of contact – and it all adds up cumulatively and leads to a greater mortality.”

Professor Gale also believes that people do not have a correct view of who is at risk for cardiovascular problems and heart attacks.

“There’s misconception amongst the general public and healthcare professionals about what heart attack patients are like,” he said.  “Typically, when we think of a heart attack patient, we see a middle-aged man who is overweight, has diabetes and smokes. This is not always the case; heart attacks affect the wider spectrum of the population – including women.”

The study also found that women are more likely to suffer from illnesses such as diabetes and high blood pressure, though this had little effect on the mortality rates.

The next step in improving treatment for women is likely altering people’s misconceptions of who is at risk and better educating them on the topic.

“We urgently need to raise awareness of this issue as it’s something that can be easily changed,” Professor Jeremy Pearson of the British Heart Foundation, which helped fund the study, said. “By simply ensuring more women receive the recommended treatments, we’ll be able to help more families avoid the heartbreak of losing a loved one to heart disease.”

With an increase in awareness and changes in treatment, we can be hopeful that the next decade will see a decrease in the gap of mortality rates for STEMI patients, as well as better health for women in general.

Featured Image by Andrew Malone on Flickr

Attribution 2.0 Generic (CC BY 2.0)

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