Women lack heart treatment, study says
Published: Tuesday, January 21, 2003 at 6:01 a.m.
Last Modified: Monday, January 20, 2003 at 9:52 p.m.
On the Net
Annals of Internal Medicine: http://www.annals.org
American Heart Association: http://www.americanheart.org
The study found that doctors often fail to prescribe aspirin, beta blockers and cholesterol-lowering drugs to these women, even though the medications have been shown to prevent further heart attacks or other heart trouble.
The researchers did not look at how often these drugs were offered to men. But other studies have shown that men and women alike are undertreated for heart disease, and women are treated even less aggressively than men.
"Doctors in our society just aren't good with prevention efforts," said study co-author Dr. Michael Shlipak of the University of California at San Francisco.
Shlipak said there could be a number of reasons for the findings. There is a lingering myth that heart disease is primarily a man's disease, he said. Moreover, both doctors and patients fear the side effects of some preventive drugs, he said. The study, in today'sTuesday's Annals of Internal Medicine, involved 2,763 postmenopausal women with heart disease. All had suffered heart attacks or chest pain caused by blocked arteries, or had undergone bypass surgery or angioplasty.
Researchers found that beta blockers, which slow the heart rate, were used by only a third of the women who should have been taking them. Only half the women who qualified for cholesterol-lowering drugs took them.
Even aspirin was underused: Though all of the heart attack survivors in the study should have been taking it, only 80 percent did.
The research highlights "a terrible discrepancy between what we know and how we treat our sisters and mothers," Drs. Andrew Miller and Suzanne Oparil of the University of Alabama at Birmingham said in an accompanying editorial. "This report confirms previous evidence that women with (heart disease) are being undertreated in the United States."
Dr. Naveed Malik, a cardiologist at the Ochsner Clinic Foundation in New Orleans, said heart disease often goes undetected in women in the first place. For example, a woman complaining of chest pain might be diagnosed with heartburn.
"But similar symptoms in men might prompt (doctors) to think about coronary artery disease first," said Malik, who was not connected with the study.
Dr. Howard C. Herrmann, a cardiologist at the University of Pennsylvania Medical Center, said both men and women are being undertreated for heart disease.
"I think this should serve as a wake-up call to physicians and patients that they need to more aggressively use appropriate drugs like aspirin, beta blockers and ACE inhibitors in women with heart disease," he said.
The findings were extracted from a 1993-98 study of the effects of hormone supplements on the heart. That study was funded by Wyeth-Ayerst Laboratories, maker of the best-selling hormone brands. Last July, a landmark study declared that the increased risk of heart disease and breast cancer from using hormones far outweighs any health benefits.
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