Women suffer worse heart disease outcomes than men, finds study

Women suffer worse outcomes when diagnosed with and treated for cardiac issues, the number one killer in the world, according to an analysis of 15 studies from 50 countries, including India. The analysis, published in the peer-reviewed journal “Arteriosclerosis, Thrombosis, and Vascular Biology”, showed that when women experience heart issues, they may suffer more than the typical chest pain.

Symptoms such as vomiting, jaw pain and abdominal pain are also common. If these symptoms are missed by doctors or by the patients themselves, diagnosis and treatments are delayed.

“We found stunning differences between men and women in the diagnosing of cardiovascular disease, treatment and symptoms,” said Associate Professor Mahdi O. Garelnabi of the Zuckerberg College of Health Sciences from the University of Maryland School of Medicine.

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“Women tend to go to the hospital later than men after the onset of symptoms and physicians are not admitting women to the hospital at the same rates as men,” he added.

The analysis also pointed out that heart attack rates among younger women are climbing. In recent years, heart attacks among women aged 35 to 54 increased from 21 percent to 31 percent, while the rate for men rose only slightly, from 30 percent to 33 percent.

In another study of nearly 15,000 patients with coronary artery disease, among younger patients, women were associated with a six-fold increased risk of dying within 30 days.

“It’s alarming that heart attack rates are increasing in younger women,” said Garelnabi. “Risk factors that are unique to women include premature menopause, endometriosis and hypertension disorders during pregnancy.”
The analysis showed another difference between genders when a blood test, a high-sensitivity troponin assay biomarker, is used by doctors to detect heart damage.

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The results of the biomarker may not be elevated for women the same way it is for men, giving doctors misguided information.

“There’s nothing wrong with the biomarker,” said Garelnabi, adding that “there’s something wrong with the way the guidelines are explained per gender for interpreting the biomarker. It’s possible that a woman’s hormones are interfering with the results of the test”.

It’s not just the patient’s gender that plays a role in cardiac outcomes, the gender of the doctor also makes a difference, according to the analysis.

In one of the studies of patients treated in Florida hospitals, the results showed that when women were treated by women doctors, their probability of death rate was reduced from 11.9 per cent to 5.4 percent relative to the entire study population.

“The data show that the differences by gender for symptoms, hospital admittance, diagnoses and treatments have resulted in women experiencing worse outcomes than men for cardiovascular disease,” Garelnabi said.