Study reveals disparities in post-heart attack treatment between women and men

Women receive fewer aggressive treatments after a heart attack than men, a pattern that emerges even as a greater percentage of women than men die or become disabled due to heart attacks, according to a new study.

The new report by the Blue Cross Blue Shield Association (BCBSA) and Blue Health Intelligence (BHI) shows that following a heart attack, women are 27 percent less likely than men to receive angioplasties to open clogged arteries. The same data shows that women are 38 percent less likely than men to undergo coronary bypass surgery and nearly 5 percent less likely to receive coronary angiography, a diagnostic procedure that involves an X-ray examination of blood vessels. The analysis is based on independent Blue Cross and Blue Shield (BCBS) companies’ 2014 claims data and reflects care provided to 43 million BCBS commercially insured members ages 18 through 64.

“Heart disease is more prevalent in men, but more deadly for women,” said Trent Haywood, M.D., J.D., chief medical officer for BCBSA. “Our analysis shows that women receive significantly fewer aggressive treatments after a heart attack than men despite the fact that a greater percentage of women die from heart attacks. These findings of variations in practice patterns demonstrate the need for additional research.”

The report, titled “Disparities Identified in Post-Heart Attack Treatment between Women and Men,” shows that in 2014, 0.73 out of every 1,000 women experienced a heart attack compared to 1.95 per 1,000 men.* Although heart disease is more prevalent in men, women are more likely than men to die within one year of a heart attack, have another heart attack within six years and be disabled with heart failure within six years, according to the American Heart Association.

The data also shows wide geographic differences in heart attack rates among women and men. Women living in Kentucky and Ohio are three times more likely to suffer heart attacks than women residing in Colorado, Idaho and Wyoming. Men living in Vermont are more than twice as susceptible to heart attacks as men living in Montana.

“As healthcare moves towards the era of personalized or precision medicine, the differences between women and men may play an increasing role in diagnosis and treatment,” Haywood said. “The findings from this report highlight the need for additional examination of treatment patterns and social determinants of heart health at the local and national level.”

"With the treatment of women’s hearts largely based on medical research on men for the last 50 years, the report’s findings around disparities in care for women unfortunately come as no surprise,” said British Robinson, chief executive officer of the Women’s Heart Alliance. “It’s time to fight back. This report reinforces our mission and our nationwide Fight the Ladykiller campaign to build greater awareness and knowledge of the women’s heart health epidemic and gender differences."

“Women’s hearts are under-researched, under-treated and get misdiagnosed far more often than our male counterparts — facts further underscored by The Health of America Report," said Dr. Paula Johnson, professor of medicine, Harvard Medical School and executive director of the Connors Center for Women's Health, Brigham and Women's Hospital. “With heart disease as the leading cause of death among women in the U.S., more research to understand the sex differences in heart disease in order to diagnose and treat women’s unique hearts should be a national priority.”

This study of disparities in post-heart attack treatment between women and men is the third report by Blue Cross Blue Shield, The Health of America Report, a collaboration between BCBSA and BHI, which uses a market-leading claims database to uncover key trends and provide insight into healthcare affordability and access to care.


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