Doctors have long known that women are nearly twice as likely as men to die in the first month after a heart attack. But a new study published in the Journal of the American Medical Association looked behind this statistic to discover that gender may not directly influence survival outcomes after a heart attack heart attack outcomes.
Theresa Volpe, 40, barely survived a massive heart attack two years ago. She said despite ongoing symptoms of dizziness and fatigue, when her chest pains struck, many people thought she had indigestion.
"I was so dizzy and light headed -- my arms felt heavy and weighed down," said Volpe. "The paramedics came and looked me over and said, well your heart rate is not so high maybe it's just anxiety."
But once a cardiologist saw her, she was immediately airlifted to a specialist center where it was discovered one of Volpe's major arteries was 90 percent blocked by plaque.
"I was lucky because a lot of women don't survive a heart attack," said Volpe, who is now a spokeswoman for the Go Red for Women campaign of the American Heart Association.
To discover more about the difference in heart attack survival rates between the sexes, Dr. Jeffrey Berger and his colleagues at the New York University School of Medicine analyzed the medical records of more than 130,000 heart attack patients (72 percent men and 28 percent women) that were part of 11 international studies between 1993 and 2006.
Among all the studies, women died at a 9.6 percent rate compared with a 5.3 percent rate for men in the first month after a heart attack. Yet the study pointed out key differences between men and women in these statistics.
Women were having heart attacks at an older age than the men. Women were also more likely to have diabetes, high blood pressure and heart failure while men were more likely to smoke, to have had a previous heart attack and have a previous bypass surgery.
Once the researchers compared men and women of the same age and health status, then the gender difference in survival rate disappeared.
"[In our study] you see that women have almost a twofold increase risk for death after 30 days, which was found before, but the beauty of our study is we're able to look at reasons why this is," said Berger. "If you account for age, clinical risk factors that differ like hypertension, high cholesterol and numbers of arteries are blocked, there is not a difference."
"It's not being a man or woman that puts you at higher risk, it's these other factors," said Berger. Rather than focus on treating men and differently, Berger hoped doctors would start looking at treating older heart attack victims with specific health complications differently than other heart attack victims.
Indeed, Berger's study led some cardiologists to wonder if some of the differences between men and women in heart disease have been overblown.
"The so-called 'gender differences' in heart disease have been hyped to a large extent," said Dr. Steven Nissen, director of the Joseph J. Jacobs Center for Thrombosis and Vascular Biology at the Cleveland Clinic Foundation in Cleveland, Ohio.