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New study: Women more likely to die after a heart attack due to unequal treatment

A study published in the Journal of the American Heart Association has found that women are up to three times more likely to die following a serious heart attack than men as a result of receiving unequal care and treatment.

Researchers at the Karolinska Institute in Sweden and the University of Leeds used data from Sweden’s online cardiac registry, SWEDEHEART, to monitor the long-term health of 180,368 patients who had a heart attack between 1 January 2003 and 31 December 2013.

Analysis of the data showed that women were more likely to suffer from other illnesses, such as diabetes and high blood pressure, but these did not fully account for the excess mortality. Women were also less likely to report chest pain and more likely to dismiss symptoms, but this did not explain why they were not receiving the same treatment as men after they were diagnosed.

From their very first point of contact with healthcare professionals, women are less likely to receive the same diagnostic tests, leading to them being 50% more likely to be initially misdiagnosed. Researchers also found that women were 34% less likely to receive procedures which clear blocked arteries, such as bypass surgery and stents, 24% less likely to be prescribed statins, which help to prevent a second heart attack, and 16% less likely to be given aspirin, which helps to prevent blood clots. This is despite guidelines suggesting all three treatments should be given to both genders.

The study found that when women did receive all the recommended treatments, the gap in mortality between the sexes decreased dramatically.

Co-author of the study Professor Chris Gale, from the University of Leeds suggested that heart attacks are typically seen as a male issue. “We need to work harder to shift the perception that heart attacks only affect a certain type of person. 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 findings from this study suggest that there are clear and simple ways to improve the outcomes of women who have a heart attack – we must ensure equal provision of evidence-based treatments for women.”

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, which part funded the study, said: “Heart attacks are often seen as a male health issue, but more women die from coronary heart disease than breast cancer in the UK. The findings from this research are concerning – women are dying because they are not receiving proven treatments to save lives after a heart attack. We urgently need to raise awareness of this issue as it’s something that can be easily changed. 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.”

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Source: Alabas, O. A., Gale, C. P., Hall, M., Rutherford, M. J., Szummer, K., Lawesson, S. S., Jernberg, T. (2017). Sex Differences in Treatments, Relative Survival, and Excess Mortality Following Acute Myocardial Infarction: National Cohort Study Using the SWEDEHEART Registry. Journal of the American Heart Association, 6(12). doi:10.1161/jaha.117.007123