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More evidence of gender differences in cardiovascular assessment, care

July 21, 2016 | Patricia Harriman
Cardiologist Dr. Shaista Malik

Dr. Shaista Malik


Since the 1980s, deaths from cardiovascular disease in developed countries have steadily decreased. About 50 percent of that progress is due to improved primary prevention, starting with an assessment of the patient’s risk factors.

However, a recently released European survey found that male general practitioners are more likely to consider heart disease a “man’s issue” and fail to assess cardiovascular risk in female patients. This lack of primary prevention is one of the reasons that cardiovascular disease has decreased more in men than in women, says UC Irvine Health cardiologist Dr. Shaista Malik.

“Most of us think that heart attacks are an older person’s ailment that usually affects men, but in fact, cardiovascular disease, which includes heart attack, stroke, heart failure and valve problems, is the number one killer in the country, and paradoxically younger women have worse survival after a heart attack compared to younger men.” says Malik, medical director of the UC Irvine Health Preventive Cardiology Program and expert in women’s cardiovascular health.

The European study found that the patients least assessed for CVD risk factors were female patients seen by male general practitioners, with a 44 percent lower chance. The study found that when a female patient was seen by a female physician, there was a 28 percent less chance of being assessed for risk.

Heart disease is the No. 1 health threat to American women over age 25, responsible for six times as many deaths each year as breast cancer. Earlier this year, the American Heart Association, for the first time ever, issued a scientific statement on heart attacks in women, which said in part that “women are understudied, underdiagnosed and undertreated.”

“Gender differences in heart health were first identified during the WISE study, conducted between 1996 and 2000, but it takes time for physicians and patients to adjust their thinking,” Malik said. “Recognition by the American Heart Association and the findings of this European study are helping to heighten awareness, increase doctors’ willingness to diagnose and treat women’s heart health, and also encourage more women to pay attention to their heart health. Women who do experience an episode must go for treatment, complete the treatment, and make the necessary medication and lifestyle changes.”

The lead author of the European study, Dr. Raphaelle Delpech, a general practitioner at Paris XI University and INSERM U1018 in Paris, France, said that she thinks most general practitioners will be surprised by the findings, ensuring that they will be more diligent in assessing cardiovascular risk in all patients.

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