Although more women than men have died of
cardiovascular disease since 1984, a multicenter study led by a UC
scientist suggests that women are less likely than men to receive the
recommended treatments and procedures for heart disease.
Published in the March 15 Journal of the
American College of Cardiology, the study is a continuation of work
reported last year at the American College of Cardiology (ACC)
Scientific Assembly in New Orleans.
Principal investigator Andra Blomkalns,
MD, director of the emergency medicine residency training program at
the College of Medicine, says that while treatment of heart patients
overall is improving, the benefit does not seem to translate to women.
Fortunately, however, although the women
in the study did not receive recommended treatments as frequently as
men, there was no difference in their death rate or other health
Dr. Blomkalns and her team, which
included Brian Gibler, MD, chairman of the Department of Emergency
Medicine, studied nearly 36,000 women around the country with a heart
condition known as non–ST-segment elevation acute coronary syndrome.
Women make up 40 percent of patients with this condition, and their
risk of complications is 15 to 20 percent higher than that of men.
Yet even though the researchers took into
account age, disease severity and other factors linked with less
aggressive treatment, they still found women were receiving less than
"guideline" treatments recommended by the ACC and the American Heart
"I feel that clinicians, and even
patients, don't believe that women have the disease," says Dr.
Blomkalns. "Coronary heart disease has been seen as a 'man's disease'
for so long that the attitudes, therapies and interventions haven't
been thought of as gender neutral. Women likely present somewhat
differently with their symptoms, and the tests we use to find heart
disease might need to be chosen and interpreted differently for women."
The fact that the researchers found no
apparent difference in death rate compared with men, Dr. Blomkalns
says, "is the topic of more research. It just shows that women and men
are different when it comes to heart disease. They present and act
differently when they are treated. We haven't begun to understand the
implications of these differences."
UC and University Hospital are
col-laborating with over 400 hospitals led by Duke Clinical Research
Institute, Durham, N.C., in a nationwide quality-improvement initiative
known as CRUSADE (Can Rapid Risk Stratification of Unstable Angina
Patients Suppress Adverse Outcomes with Early Imple-mentation of the
ACC and AHA Guidelines).