New research shows evidence of a gender divide in hospitals that may be putting some women at a disadvantage.
A study published Monday in the Canadian Medical Association Journal found that women experiencing acute heart problems waited longer than men, on average, to receive important treatments in the accepted benchmark times, potentially putting their health at further risk.
But the results don't suggest blatant discrimination is at play, said Dr. Roxanne Pelletier, lead author of the study and postdoctoral fellow in clinical epidemiology at the Research Institute of the McGill University Health Centre. The actual explanation is likely much more complex and tied to lack of understanding of heart disease in women and inherent differences in how men and women experience heart attacks.
The study looked at more than 1,100 patients between 18 and 55 admitted to hospital for heart attacks and angina. Most of the patients were in Canada, but one hospital in the United States and one in Switzerland was also involved in the study. Only 29 per cent of women received an electrocardiogram in less than 10 minutes, whereas nearly 40 per cent of men did. Similarly, only 32 per cent of women received clot-busting drugs in less than 30 minutes, while about 60 per cent of men did.
The study did not prove a cause-and-effect relationship between being a woman and waiting longer for treatment, said Dr. Beth Abramson, cardiologist at St. Michael's Hospital in Toronto and spokesperson for the Heart and Stroke Foundation. (The foundation provided funding for the study but Abramson was not involved with the research.)
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The message it delivers, Abramson said, is that symptoms of a heart attack often look different in men and women, and that patients, as well as health-care professionals, need to do a better job of recognizing that reality.
Many women, for instance, don't experience chest pains when they are having a heart attack, which may cause their doctors to spend time trying to find the problem elsewhere.
Abramson noted that patients don't need to have "classic" symptoms before seeking medical attention.
"It's a study that tells me the importance of having … Canadian men and women know if they are having symptoms, to take it seriously and come to the emergency room," she said.
She added that even if they aren't sure, patients should make it clear to health-care staff when they get to the hospital they think the problem may be heart-related.
Dr. Robert Reid, deputy chief of the division of prevention and rehabilitation at the University of Ottawa Heart Institute, said doctors and other health providers need to be more aware that women are different than men, but that their risk of heart disease is just as serious.
"Hopefully, if there are biases that are built in … we can understand them and kind of compensate for them appropriately," Reid said.