Gender Bias in the ER?

Oct. 2, 2007 — -- Women are much less likely than men to receive a range of care for heart problems at the hospital, even when they arrive while having a heart attack, according to a new study of Medicare patients.

"It is a well documented trend in health care that is not changing," said Dr. Sharonne Hayes at the Mayo Clinic. "Women get less treatment, and they get it later, compared to men who have the same symptoms or conditions."

For tips on what women can do to increase the chances that they will receive the care they need for their hearts click here.

Nowhere in the study are the disparities more glaring, and the consequences more deadly, than what happens to women during and after a heart attack. And it begins within minutes of arriving at a hospital.

The study, published in the Journal of the American Medical Association, found women are two to three times less likely to get defibrillators than men are. The tiny, implantable devices, which keep an ailing heart beating, can mean the difference between life and death when trying restore a heart's natural rhythm.

Amazingly, even in the midst of a heart attack, women are 16 percent less likely than men to be seen by a cardiologist, and are treated, instead, by an internist or family physician.

The Duke University of Medicine study also found women are 15 to 30 percent less likely than men to get an angiogram to detect blocked arteries, and without one, doctors would never know what treatment the patient needs.

When blockages are discovered, women are 12 percent less likely to receive clot-busting drugs. And if they survive, women are 10 percent to 15 percent less likely to get medications to prevent a second heart attack, such as essential drugs to thin the blood, reduce cholesterol and lower blood pressure.

"It is frustrating. Many doctors do not see heart disease as a woman's disease. They don't look for it or treat it aggressively," said Dr. Holly Andersen at New York Presbyterian Hospital.

One possible explanation: Early studies suggested women could suffer more complications from heart treatments, but that's no longer the case, and early intervention is considered essential.

There is one category in cardiology where women do have the lead — each year, more women than men die from heart attacks.

For a comprehensive listing of Medicine on the Cutting Edge reports with John McKenzie, click here.