When it comes to heart disease, the level of care that women receive lags significantly behind men regardless of symptoms, a new study reported.
For this study, the research team headed by the Duke Clinical Research Institute compared how doctors diagnosed and assessed the risks involved with coronary heart disease in more than 10,000 male and female patients from the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE). The patients were suspected of having coronary heart disease but did not have a history of a heart condition.
The researchers found that even when men and women had the same initial symptoms, such as chest pain and shortness of breath, women still did not receive the same level of care as men. The researchers added that when women had more risk factors for heart disease, doctors continued to assess them as having lower risk. The discrepancy between the level of care that men and women receive can lead to potentially dangerous health consequences for women.
Overall, the researchers found that roughly the same number of women and men complained of chest pain. Chest pain, however, was often described differently. Men were more likely to report experiencing a dull ache or a burning sensation while women were more likely to characterize their pain as tightness or pressure.
The researchers also found differences in heart disease symptoms, which could explain why doctors assessed risk differently between the two sexes. Women were more likely to have back, neck or jaw pain and palpitations, whereas men were more likely to be afflicted by fatigue and weakness. These symptoms, however, generally were not the patients' first complaint.
"Our findings suggest there might be need for heart-health resources specifically aimed at women, because much of what is provided is for men, and there are significant sex-based differences," said lead author Kshipra Hemal of the Duke Clinical Research Institute.
Hemal added that current guidelines used to predict heart disease tend to skip over factors, such as depression, sedentary lifestyle and family history. By not taking into account these three factors, which are generally reported more often by women than men, women's risk of heart disease might not be completely accurate. The researchers stressed the importance of updating heart disease predictor models to account for these differences.
"Previous studies have compared differences in demographics, risk factors, and symptom profile between men and women, but most of these focused on patients with an existing diagnosis of heart disease," said senior author Pamela Douglas, the Ursula Geller Professor for Research in Cardiovascular Disease at Duke University School of Medicine. "Our study is the largest of its kind looking at patients with stable chest pain or other symptoms suggestive of coronary artery disease, which is a much more common occurrence. Establishing a diagnosis is arguably more difficult among these patients. Our findings should help clarify that there are differences between men and women that we need to take into account."
The study's findings, which will be presented at the American College of Cardiology's 65th Annual Scientific Session, were published in the Journal of the American College of Cardiology - Cardiovascular Imaging.
