According to the American Heart Association, women face a stronger heart attack risk than men – they are 20% more likely to develop heart failure, and to die
The American Heart Association analysed data on over 45,000 patients, who were hospitalised for a first attack between 2002-2016. They focused on two types of heart attack – the first, a severe, life-threatening one called ST-segment elevation myocardial infarction (STEMI), and the second a less severe situation. The second, Non-STEMI, is more common.
They followed patients for just over 6 years, with 13,860 post-heart attack women among the group being observed.
“Identifying when and how women may be at higher risk for heart failure after a heart attack can help providers develop more effective approaches for prevention,” said lead study author Justin A Ezekowitz, MBBCh, MSc, a cardiologist and co-director of the Canadian VIGOUR Centre at the University of Alberta in Edmonton, Alberta, Canada.
“Better adherence to reducing cholesterol, controlling high blood pressure, getting more exercise, eating a healthy diet and stopping smoking, combined with recognition of these problems earlier in life would save thousands of lives of women – and men.”
What did they find after six years of observation?
Their findings were stark for the situation of women with heart problems.
Women were more likely to be an average 10 years older than men at the time of their heart attack, usually an average age of 72 years versus 61 for the men. Women also had more complicated medical histories at the time of their heart attacks, including high blood pressure, diabetes, atrial fibrillation and chronic obstructive pulmonary disease, risk factors that may contribute to heart failure. Women were seen less frequently in the hospital by a cardiovascular specialist: 72.8% versus 84% for men.
Regardless of whether their heart attacks were the severe or less severe type, fewer women were prescribed medications such as beta blockers or cholesterol-lowering drugs. Women also had slightly lower rates of revascularisation procedures to restore blood flow, such as surgical angioplasty.
The development of heart failure either in the hospital or after discharge remained higher for women than men for both types of heart attack, even after adjusting for certain other elements.
“Close enough is not good enough,” said Kaul, who is also the Sex and Gender Science Chair from the Canadian Institutes of Health Research.
“There are gaps across diagnosis, access, quality of care and follow-up for all patients, so we need to be vigilant, pay attention to our own biases and to those most vulnerable to ensure that we have done everything possible in providing the best treatment.”
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