Women losing out in heart care to men

A perception that cardiovascular illness is mostly a male problem has led to poorer treatment for women with heart disease, leading doctors said recently.

Professor Caroline Daly of Royal Brompton Hospital in London told the European Society of Cardiology congress that despite the fact that heart attacks and strokes kill a higher percentage of women than men, the common perception that women were less likely to suffer from heart disease remained.

She said women with chest pains were 20 percent less likely to be referred for an exercise test, the first way of checking for angina, and were 40 percent less likely to have an angiograph, or x-ray, to determine the extent of any coronary obstruction, she said.

A study of nearly 3,800 patients across Europe also found that women with angina were less likely to get life prolonging heart drugs, such as aspirin and cholesterol-lowering pills.

"Women are under-investigated and under-treated, even though their symptoms are worse and they have a worse prognosis," Daly told reporters.

Professor Ian Graham of the Adelaide and Meath Hospital in Dublin said the idea that women were protected from heart disease was an illusion. They simply contracted the condition later than men -- but once it set in it tended to kill them faster.

Most women's biggest fear is breast cancer. Yet heart disease kills twice as many women as all cancers put together, and is responsible for 55 percent of deaths in women compared to 43 percent in men.

Daly said there were some encouraging signs that the bias in care was starting to change but more needed to be done to improve diagnosis and treatment in women.

A crucial element should be more research on how women respond to heart treatments, doctors said.

The fact that women are under-represented in clinical trials means cardiologists are often in the dark as to how drugs may work differently in their bodies, due to hormones, body weight and other biochemical factors.

Already known gender differences include the fact that women are twice as likely as men to develop a persistent cough if given ACE inhibitors, a commonly prescribed type of drug for high blood pressure.