Heart Attacks In Women
Italian researchers looked into the question of why more women than men die after heart attacks in a study involving 471 women and 1,052 men who had heart attacks between 2015 and 2017. The investigators reported that deaths were similar in both sexes while they were hospitalized, but during the 264 days following discharge, more women than men died. The team found that after being released as outpatients only 55 percent of the women received optimal medical therapy compared to 64 percent of the men.
Women also were less likely than men to receive invasive procedures. The researchers reported that receiving optimal medical therapy after a heart attack was independently linked with a roughly 50 percent decrease in all-causes of death, while being female wasn’t an independent predictor of death after a heart attack. Study leader Claudio Montalto of Italy’s University of Pavia said the study suggests that it is not being female that causes more deaths – “it is receiving fewer recommended drugs. In fact, getting the right medication nearly halves the risk of dying.”
My take? It has long been true that doctors treat women with heart attacks less aggressively than they do men. Women are less likely than men to receive such drugs as beta-blockers, ACE inhibitors or even aspirin after a heart attack. In addition, rates of such treatments as angioplasties (to open a blocked coronary artery), stents (devices used to hold coronary arteries open) and coronary artery bypass surgery are far lower among women than men; and only 28 percent of implantable defibrillators go to women. Clearly, physicians and researchers still need some education and consciousness-raising about heart disease in women.
Claudio Montalto, “Women Receive Less Recommended Drugs After a Heart Attack,” presentation, European Society of Cardiology, April 17, 2020.