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Women & men differ in heart disease traits and treatment

ss than men.

Overall, people of both sexes who had normal-looking vessels or mild stenosis were less likely than those with more advanced disease to get either interventional or medical therapy.

But when women and men with the same mild level of stenosis were directly compared, the women were statistically less likely to get in-hospital aspirin. They were also less likely to be prescribed beta-blockers on discharge.

Six months after discharge from the hospital, there was no difference overall between the genders in the number of patients who had experienced one of the following: death, a non-fatal heart attack, a stroke or other cerebrovascular accident, or readmission to the hospital. But women who had had an angioplasty were slightly more likely than men to meet a combined endpoint that included all those outcomes.

The bottom line, says Dey, is that there's a difference in disease and treatment that both doctors and patients need to pay attention to.

"Women may on the whole have more mild-looking disease than men, but even when they had similar-looking disease they were still under-treated," she says. "If your angiogram looks the same you should be getting the same medical therapy. Even the differences in age between the two gender groups shouldn't make a difference in medical management, though it may affect the use of interventional procedures."

Over all, Eagle emphasizes, the findings mean that physicians should be more aggressive with prescribing medications to women with signs of heart disease, because those drugs can help keep blood vessels clear, prevent clots, and keep vessels from hardening.

And women should speak up for themselves, adds Dey. "Believe yourself and your symptoms, and bring them to the attention of your physician to figure out how to help you," she says. "Don't be afraid to ask what else they could be doing for you."

As for the root cause of the d
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
9-Nov-2003


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