Heart Disease: Symptoms and Prevention

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How Women Get Shortchanged

Research shows that women with heart disease also are less likely to receive potentially life-saving treatments. "After a heart attack, they're less likely to be sent to cardiac rehabilitation, or to get medications like beta blockers, ACE inhibitors, or even aspirin to reduce the risk of a second heart attack," says Dr. Legato. Although nearly equal numbers of men and women get heart disease, women receive only 33 percent of angioplasties (insertion of a balloon-tipped catheter to reopen blocked vessels), stents (mesh tubes used to hold clogged vessels open), and bypass surgeries. All this may explain another deadly disparity: 38 percent of women die within a year of their first heart attack, compared with just 25 percent of men.

Until recently, doctors didn't know much about women's heart disease or the best treatments because, in the past, most major research studies were conducted on men. Indeed, women comprise only 25 percent of participants in all heart-related studies done to date, reports the National Coalition for Women with Heart Disease. "There's a Catch-22: Doctors don't use interventions like angioplasty or bypass surgery as aggressively for women as they do for men, because the effectiveness in women hasn't been studied as extensively," says JoAnn Manson, MD, chief of preventive medicine at Harvard's Brigham and Women's Hospital, in Boston. "As a result, women with heart disease sometimes end up being deprived of treatments that have already been shown to be beneficial in men."

However, now that more women are being enrolled in randomized clinical trials -- the gold standard of research -- physicians are finally starting to get answers about what works and what doesn't. Although doctors used to think ACE inhibitors weren't as effective for women, in October 2002, the Heart Outcomes Prevention Evaluation (HOPE) Study of 2,480 women who had heart disease or were at high risk of getting it showed that the medication has the same life-saving effects for women as it does for men. The women who received it were 38 percent less likely to die from cardiovascular disease. Another large 2002 study at Cardiac Centers of Louisiana found that beta blockers increase survival in women just as much as they do in men.

Continued on page 4:  Prevention Is Key


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