How gender bias affects the treatment of heart disease in women
Compared with Men, Women with Heart Disease More Likely to Report More Treatment and Care Disparities

The misconception that myocardial infarction (MI) is a ‘male disease’ is costing women’s lives, according to an urgent new BHF campaign launching this week.

Cardiovascular disease is a leading cause of death in women worldwide. According to a recent report published by the British Heart Foundation, women with coronary heart disease have a two-times higher risk of death than those with breast cancer in the UK.

Gender bias against women in the field of cardiovascular diseases has been known for decades. Women with cardiovascular disorders are more likely to be misdiagnosed and/or undertreated and have higher mortality rates than men.

One potential reason for this high mortality is the delay in seeking medical help from women. They often perceive heart attack, or cardiac arrest, as a “male problem”, and thus, do not recognize heart attack-related symptoms on time.

It has been estimated that the average duration between symptom onset and seeking medical help is 1.8 – 7.2 hours for women. Whereas, for men, the average duration is 1.4 – 3.5 hours.

More reasons to be worry

Misdiagnosis of cardiovascular conditions is another potential reason for higher mortality among women. It has been estimated that women are 50% more likely to be misdiagnosed than men. Misdiagnosis of heart attack could increase the risk of death by 70% after 30 days of the symptom onset.

Women with cardiovascular diseases exhibit a wider range of symptoms than men, including stomach pain and nausea. However, because of the disproportionately low representation of women in clinical trials, it remains largely uncertain whether there are actually gender disparities in cardiovascular symptoms.

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Inadequate treatment is another potential factor associated with a poor prognosis of cardiovascular diseases in women. It has been observed that women with cardiac problems are less likely to receive life-saving medicines on an emergency basis. Similarly, women who have already suffered a heart attack are less likely to receive medicine to prevent a second heart attack.

Besides impacting diagnosis, implicit gender bias of physicians can influence their therapeutic decision-making process. A relatively higher mortality rate has been observed among female cardiac arrest patients who have been treated by male physicians.

To reduce gender bias against women in the field of cardiovascular diseases, the British Health Foundation has identified three main domains that need to be addressed. These domains include increasing awareness, understanding and tackling gender inequality, and arranging more funds to support cardiovascular research in women.