"This leads to later presentation with heart attack and slower recognition by care providers," said Wood. "Often the damage to the heart muscle has been done once women present."
"Also, women are more likely than men to have heart attacks without tight blockages in the arteries," she continued. "This small vessel disease is more challenging to diagnose and treat."
Dr. Susan Bennett, director of the GW Women's Heart Program at George Washington University, said physicians often see an elderly woman who has the "fragility factor," and, as a consequence, tend to be more reluctant to operate on them.
"What is really worth thinking about is that women have a lot more risk with procedures than men, such as bleeding, kidney failure," continued Bennett, who said it is unclear why women have higher rates of these serious side effects.
"And in my mind there should be much more attention paid to knowing why women have more drug or procedural risks, and what can be done to minimize it so that she can obtain the same degree of overall benefit," Bennett said.
Dr. Sharonne N. Hayes, director of the Women's Cardiovascular Clinic at Mayo Clinic, added that under-treatment could remain a problem for women, whether it is treating heart disease through aspirin, statins, beta blockers or procedure use, but there is an even further explanation that is necessary.
Hayes noted she is "wary" of papers that only report percent differences in mortality as this is particularly misleading if death rates are already low. The published paper did not look at overall incidence of heart disease in men and women.
Hayes broke it down by saying: "If mortality in women is 2 percent and 1.5 percent in men, then that would be a 30 percent or so of excess mortality, but both numbers would be exceedingly low."