Men are twice as likely to get state-of-the-art medical treatment for their heart attacks even though heart disease kills almost as many women as men each year, a major study of nearly 5,000 patients in the Seattle area shows.
The findings "are disturbing" and "call into question whether women are being appropriately treated for heart attacks," says the University of Washington research scientist who led the investigation.
Charles Maynard, reporting today at an American Heart Association conference in Anaheim, Calif., said his research team found that various "clot buster" drugs that restore blood flow to the heart were given to 26 percent of the men while the drugs were administered to only 14 percent of the women.
The Seattle group found another inequity in the use of balloon angioplasty to reopen diseased arteries. The study showed that men were twice as likely to have angioplasty as women.
In this technique, a tiny balloon on the end of a catheter, or narrow piece of plastic tubing, is inflated to squash blockages against the walls of coronary arteries. This procedure is used in patients who have artery narrowings and chest pain despite medical treatment.
Of about 500,000 people who die of heart attacks each year in the United States, about 48 percent are women, according to the American Heart Association. The Seattle researchers studied 1,659 women and 3,232 men.
Since men have been receiving these drugs and undergoing angioplasty for a longer time, Maynard said, physicians may feel more comfortable treating men than women. However, he stressed that the treatments are as safe for women and there is no evidence showing women are innately less responsive to clot-busting drugs or angioplasty.
In the Seattle study, there were no differences in survival rates between the women and men who received these therapies.
Future studies will be designed to pinpoint medical conditions or other factors that contribute to the apparent sex bias in medical treatment for heart attacks, he said.
"We don't know why women receive treatment less often than men," he said. "There are many possible explanations and we need to address why this is occurring."
Dr. Douglas Weaver, associate professor of medicine and co-author of the study, contends that even though the findings suggest women are treated disproportionately less than men, there may be significant medical reasons for this apparent discrepancy.
"There may be a true bias," he said, "but on the other hand it may be that there's something different about the way women experience heart attack -- something that foils physicians into coming to the wrong conclusion, so that the diagnosis of heart attack is initially missed and thus not treated."
A heart attack occurs when oxygen-rich blood doesn't reach the muscular walls of the heart due to narrowed arteries or a blood clot. If the clot can be dissolved and the blocked artery opened within the first few hours after cardiac chest pain, blood flow can be restored and irreversible damage to the heart can be averted.