Women May Receive Less Testing for Heart Problems

Washington, DC– One possible explanation for disparities in care for acute coronary syndrome between men and women may be that women are less likely to accept their physician’s recommendation on treatment. The results of the study were reported online recently in Annals of Emergency Medicine (“Gender Bias in Cardiovascular Testing: The Contribution of Patient Preference”).

“The well-documented “˜Mars and Venus’ differences between the sexes may play out in how patients make medical decisions,” said lead study author Judd Hollander, MD, of the Department of Emergency Medicine at the University of Pennsylvania in Philadelphia. “Prior studies of coronary patients have attributed disparities in care between men and women to access problems, differences in insurance coverage or physician biases. Our study shows that at least part of the previously noted gender disparity can be explained by patient preferences.”

Researchers enrolled 1,080 patients who came to the emergency department with symptoms of acute coronary syndrome. Women and men both preferred stress testing to cardiac catheterization, and both sexes accepted their physician’s recommendation for stress testing equally (85 percent for both sexes). However, only 65 percent of women stated that they would accept cardiac catheterization, compared to 75 percent of men. And only 67 percent of women said they would accept their physician’s recommendation for angioplasty, versus 73 percent of men. Women were less likely to desire coronary artery bypass grafting than men (61 percent versus 68 percent).

Of patients enrolled in the study who were admitted to the hospital (60 percent of the total), 38 percent of women received diagnostic testing of any kind, versus 45 percent of men. And 10 percent of women received cardiac catheterization, versus 17 percent of men.

Researchers theorized that women might be less willing to undergo diagnostic testing and treatment because they perceive their disease as less severe, or because they have lower tolerance for the risks associated with such procedures.

“The challenge for health care providers is to make sure both men and women have all the information at their disposal to make the best decisions about their own medical care,” said Dr. Hollander. “Future studies should focus on identifying the reasons that women appear less likely than men to accept physician-recommended tests and treatments for acute coronary syndrome.”

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.

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