Why are women more likely than men to die when they step into a hospital? Take a Break reports...
When we go into hospital, we place our trust — and our lives — in the hands of medical experts. But shocking new figures reveal that women who go into hospital after suffering a heart attack or heart failure are twice as likely to die as men.
The 10-year study of more than 180,000 heart attack sufferers — funded by the British Heart Foundation (BHF) — discovered that women were less likely to receive procedures which clear blocked arteries, such as bypass surgery and stents.
They were also less likely to be prescribed statins to prevent a second heart attack, and less likely to be given aspirin, which prevents blood clots.
This is despite guidelines suggesting the treatments should be given to both genders.
So what is going wrong?
Theories as to why women are treated differently from men range from gender bias to simple biology.
Women may be diagnosed later and treated less aggressively with surgery or interventional procedures. They may also be prescribed medication and referred to cardiac rehabilitation programs less often than men.
This might be due to the fact that heart attacks and heart failure were wrongly thought to be conditions unique to men.
The co-author of the BHF study, Professor Chris Gale from the University of Leeds, says: ‘We need to shift the perception that heart attacks only affect a certain type of person. Typically, when we think of a person with a heart attack, we envisage a middle-aged man who is overweight, has diabetes and smokes.
‘This is not always the case. Heart attacks affect the wider spectrum of the population — including women.’
The study found that when women did receive all the recommended treatments, the gap in mortality between the sexes decreased in almost all circumstances.
Now UK charities and medical experts are calling for greater awareness of the potential differences in care between men and women when it comes to heart failure.
Dr Husain Shabeeh, consultant cardiologist and cardiac electrophysiologist at Spire St Anthony’s Hospital says: ‘Women are often diagnosed when they are older than men. This means they are more likely to have other medical problems too, which of course then affects the prognosis and long-term outcome.
‘Also, the cause of heart failure when compared to men is less likely to be for the commonest causes such as heart attacks and a disruption to the heart’s blood supply.
‘More commonly women have heart failure symptoms due to what is called “heart failure with preserved ejection fraction” or “HFpEF”.
‘In general, this is not as well recognised, and therefore treatment is often delayed.’
Dr Shabeeh adds: ‘Heart attacks don’t always cause the classic crushing chest pain radiating to the arm. It can be different types of chest, arm or jaw discomfort, and this “atypical” presentation is possibly more common in women than it is in men, which in turn could result in missed or delayed diagnosis.
‘If any patient feels they are being fobbed off, they can ask for further clarity — if the symptoms are on-going they should ensure the doctors have ruled out serious causes.’
In such cases Dr Shabeeh recommends patients ask their doctor the following questions.
Are you sure this isn’t from the heart?
If not, are there further tests which may shed more light on this?
What do I do if symptoms don’t improve?
He adds: ‘These are all reasonable and important questions, and women have as much right to ask them as men.’
GP Dr Maria Finnegan says: ‘What these studies highlight is the need for all of us to remember that — although less likely — a heart attack or heart failure could strike a slim, non-smoking, fit female.
‘Hospitals and GPs must remember to think outside the box when people present to them to ensure that women are being given the same evidence-based treatment options as men.’
Edited by Punteha Van Terheyden
For more information, visit bhf.org.uk
Heart attack symptoms in WOMEN
Chest pain or discomfort. These symptoms are more likely to occur in people with diabetes — an indicator sometimes of the nerve damage. They are not always present, however.
Pain radiating to the arms, neck, jaw, stomach and back. Pain may be experienced in just one or all of these places — for some people the pain is severe, but for others just uncomfortable.
A feeling of indigestion or reflux-type pain — this is often ignored in the hope that it will pass.
Feeling sick, sweaty, breathless or light-headed with associated chest pain or discomfort.
A general feeling of being unwell or lethargic can also be an indicator of a heart attack when accompanied by chest pain or discomfort.
The primary symptoms of heart failure are breathlessness and fluid overload. If women experience these, they should seek medical advice.