Last updated March 6, 2017 at 3:26 pm
An Australian study published today in the journal Heart reveals that women were less likely than men to have their risk factors for cardiovascular disease (CVD) recorded by their doctors and that there are differences between men and women in the prescribing patterns for medications to manage heart disease risk.
Cardiovascular disease has long been seen as a man’s disease, but more women than men die from CVD every year. Despite national campaigns aimed at increasing awareness of CVD in women, more women around the world are being diagnosed with CVD and more women are dying from it.
This report included 53,085 patients spread across 60 Australian primary care practices and specifically looked for gender-based differences in recording of CVD risk factors such as smoking status, systolic blood pressure (BP) and high density lipoprotein cholesterol. They also looked at preventive medication use for patients with high cardiovascular risk who had enrolled in the Treatment of cardiovascular Risk in Primary care using Electronic Decision suppOrt (TORPEDO) study.
They found that women were 12% less likely than men to have their cardiovascular risk factors recorded. Typically there was less documentation of smoking status in women compared with men but there were also smaller differences in blood pressure or total cholesterol measurement.
However, women at high risk for CVD were 12% more likely to have “appropriate” preventive medications prescribed compared with men but these gender differences depended on age. Younger women (aged 35–54 years) were 37% less likely than younger men to have prescriptions for blood pressure medications, statins or antiplatelets but older women (65+ years) were 34% more likely than comparatively aged men to have these prescriptions.
Other studies have shown that a more men than women have high blood pressure until age 45 but that this reverses after age 65 with more women than men having high blood pressure. This suggest that the gender differences in blood pressure lowering strategies identified in this current study may actually be appropriate.
But recent US statistics show heart disease death rates in women between the ages of 35 and 44 are increasing while those death rates are falling in similar aged men. This study suggests that the lower rates of CVD preventive treatments among young women may be contributing to this phenomenon.
So why are there these age-dependent differences in use of preventive medication evident in women? One possibility is that there is a stereotype for young women not being at risk for CVD. Doctors may be especially vulnerable to using such stereotypes when their encounters with patients are brief and they need to make a very complex assessment of a woman’s overall health. Reliance on this stereotype in a clinical setting may be reinforcing it but the current study clearly shows that this stereotype is false and may result in premature deaths for young women from heart disease.
Lead author, PhD student Karice Hyun said “This fundamentally needs to change. We need a system wide solution to addressing these very worrying gaps in heart disease-related healthcare to ensure women are treated equally across the health system.”
- Link to original research article: heart.bmj.com/content/early/2017/02/28/heartjnl-2016-310216
- Link to editorial article: heart.bmj.com/content/early/2017/02/28/heartjnl-2016-310788