This is new research was presented by Dr Guillaume Leurent from the Centre Hospitalier Universitaire in Rennes, France at the Acute Cardiac Care Congress 2012. Shockingly, women are not just more likely to die from a heart attack we also have longer treatment delays, less aggressive treatment, more complications and longer hospital stays.
Previous studies have shown that women have a worse prognosis, possibly due to longer management delays and less aggressive reperfusion strategies,” said Dr Leurent. He used base data from 5,000 patients to find out whether there were any gender differences in the management of heart attacks and it was soon clear that women were coming off worse.
From the study it emerged that women who had heart attacks also had more frequent hypertension, less high cholesterol and less current smoking than their male counterparts. One of the major factors is that women waited 15 minutes longer than men between the onset of their symptom onset and calling for medical assistance – 60 minutes as opposed to 44 minutes. This delay is critical because it means that there is a longer period during which the heart’s blood supply is reduced.
So we wait longer before being treated, but then when we do get to hospital we are given significantly less aggressive strategies to deal with our condition. This means our mortality rate is more than double that of men – 9.0% as against 4.0%. The researchers used 3 adjustment models to see if this was due solely due to gender or whether it was due to other factors such as age, hypertension, smoking, or how their condition was managed..
The bad news is that no matter how you adjust the models, women have a higher mortality rate, more complications and longer hospital stays. Nor does it end when we (hopefully) leave hospital as we also get significantly less of the recommended treatments at discharge. Specifically that means less antiplatelet agents, beta blockers, ACE inhibitors and statins. Nor do we get our fair share of cardiovascular rehabilitation with only 27% of women being offered it as againsts 47% of men.
What Can You Do?
Dr Leuren’s advice is clear: “These results suggest that women need to be more vigilant about chest pains and request medical help quickly to reduce ischemic time. Women may take longer to call an ambulance when they have chest pains because they don’t believe it can be a myocardial infarction. Most women believe myocardial infarction is a male problem.”
Not just women, but sadly this applies to their doctors too so women need to be more proactive about seeking early treatment and asking what treatment they can be offered, what they are going to be given in terms of current treatment and aftercare. Ask for a written regime so your doctors will treat you more seriously and mention this piece of research on the greater likelihood of mortality in women.
Basically you want to behave more like a man – get treatment immediately, don’t imagine you can’t have a heart attack, and the ensure your treatment is the same as that offered to a man – if not ask why.
Of course the best plan is to avoid heart disease in the first place. Not always possible but you can reduce your risk by watching your diet, taking regular exercise, reducing your weight, minimising stress and ensuring your progesterone levels are sufficient to protect your heart.