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Fewer women than men receive recommended drugs after heart attack, study finds

Findings are “incredibly disappointing though not totally surprising" experts say.
/ Source: TODAY

Women are more likely than men to die within a year after a heart attack. Despite that, women still aren’t getting the same care as men upon leaving the hospital after an attack, a new study finds.

After checking prescription data on 88,000 Americans, researchers found 56 percent of the men had picked up intensive, or high dose, statin therapy compared to 47 percent of the women. The rest received low doses of statins. The high dose is what is recommended for both men and women who’ve had a heart attack in the latest set of guidelines, which were issued in 2013.

“Our study shows that women continue to be less likely than men to fill a prescription for high-intensity statins,” said the study’s lead author, Dr. Sanne Peters, a research fellow in epidemiology at The George Institute for Global Health at the University of Oxford. “The underutilization of high-intensity statins in women can be expected to result in a substantial additional number of preventable [heart attacks and strokes].”

The new study’s results are “incredibly disappointing though not totally surprising,” said Dr. Karol Watson, a professor of medicine/cardiology at the University of California, Los Angeles, and director of the UCLA Barbra Streisand Women’s Heart Health Program. “Women are clearly getting the short shrift.”

Watson and others suspect part of the problem is that the public still doesn’t seem to appreciate the danger women face from heart disease. “The whole idea of cardiovascular disease being a fluke in women is a gender bias,” said Dr. Marla Mendelson, medical director of the Women’s Cardiovascular Health Program at Northwestern Memorial Hospital.

A study of 500 U.S. doctors showed even physicians buy into that fallacy, Peters said. It found “sex disparities in treatment were explained largely by the provider’s lower perceived risk of cardiovascular disease risk in women,” she said.

Watson sees that bias every day. “I hear it in my referrals,” she said. “They think of women differently. Some of the old stereotypes are just not dying out.” The good news, Watson said, is that younger doctors don’t seem to have the same biases.

The fact that women tend to be more frightened of breast cancer than heart disease shows public health messages haven’t gotten through, experts said.

The heart disease stats are scary:

  • Cardiovascular diseases and stroke cause one in three women’s deaths each year, killing approximately one woman every 80 seconds.
  • Heart disease kills more women than all cancers combined.
  • An estimated 44 million women in the U.S. are affected by cardiovascular diseases.
  • Fewer women than men survive their first heart attack.
  • Women have a higher lifetime risk of stroke than men.
  • 90 percent of women have one or more risk factors for heart disease or stroke.

How to get the right treatment

A contributing factor could be patient fears of statin side effects, said Dr. Jennifer Haythe, a cardiologist and an assistant professor of medicine at the Columbia University Medical Center. “I tell them the side effects aren’t going to kill you, but heart attacks will,” Haythe said.

To make sure they are getting the right treatment, Haythe advises women to ask questions about their prescriptions. First and foremost, she said, women should ask: “Is this what the guidelines say I should be getting?”

Women should also ask about cardiac rehab. Other studies have shown women are less likely to be offered the option.

“A lot of these proper guidelines are reinforced by card rehab,” Mendelson said. “It’s a good mechanism for women to have the reinforcement of medical therapy in rehab.”