Heart Attack Gender Differences

Heart-care gap harms women, report finds

ANDRÉ PICARD

From Thursday's Globe and Mail

As many women as men now die of cardiovascular disease, but that's where the equality ends: There remains a yawning gender gap in prevention, treatment, care and rehabilitation of heart and stroke patients, according to a damning new report.

"We've come a long way baby, but not far enough," Beth Abramson, a Toronto cardiologist and spokeswoman for the Heart and Stroke Foundation, said yesterday.

The report, a compilation and analysis of published research, noted that, among other things:

Women are significantly more likely than men to die after suffering a heart attack or stroke. This difference stands even when the figures are adjusted for the fact that women tend to seek treatment when they are sicker and older;

Women are less likely than men to be referred to or treated by a cardiologist (research shows specialists sharply increase survival);

Women are less likely than men to undergo bypass surgery or angioplasty, and are less likely to receive devices such as implantable cardiac defibrillators;

Women are less likely than men to be monitored for cardiovascular risk factors such as high blood pressure and cholesterol;

The symptoms of a heart attack can be markedly different in women than men.

"It's a real concern that women's heart health has not kept pace with men's," Dr. Abramson said. "Women are underserved on the front lines compared to men."

She said there may be a number of explanations for these differences -- systemic, social and biological -- but more effort needs to be made to find the causes and solutions to the gender gap.

Linda Lewis-Daly, now 44, was hiking up Grouse Mountain outside Vancouver when she suffered a heart attack. She kept going to the top, and didn't go to a doctor until a few days later when she was home in Toronto.

"I'm a typical mom -- I put everybody else's needs ahead of my own," she said in an interview. It was only when her co-workers at Telus Corp. insisted that she went to a doctor, where Ms. Lewis-Daly was immediately referred to the emergency room.

Still, it took two days of tests before doctors realized she had suffered a heart attack. "Nobody was looking for cardiovascular problems."

Ms. Lewis-Daly immediately underwent angioplasty, a process in which a balloon is threaded into the arteries to clear them of blockages. Then she began rehab -- one of only six women in a class of 70.

Her ordeal was five years ago, but she thinks of herself as lucky. "If I were treated today, I'm afraid I would not get as good of care.

"Women and men should be enjoy the same benefits, but sadly that is not the case," said Stephen Samis, director of health policy at the Heart and Stroke Foundation.

Source: The Globe and Mail.com