More than 8,200 women in England and Wales could have survived heart attacks over the course of a decade had they received the same quality care as men, research says.
The research, part funded by the British Heart Foundation and published in the journal Heart, revealed that women were less likely than men to receive guideline care for heart attacks.
Scientists at the University of Leeds found that women in the UK had more than double the median rate of death than men in the 30 days after heart attacks. Their findings revealed that 5.2% of women died in the same period after a heart attack, compared with only 2.3% of men, representing a 2.26-fold increase in relative risk of death.
“We know women are dying due to unequal heart attack care – and now we’ve identified the shortfalls we need to target to save lives,” said Chris Gales, professor of cardiovascular medicine at the University of Leeds and senior author of the report.
“We need to tackle the false perception that heart attacks are only a male health issues,” added Nilesh Samani, medical director of the British Heart Foundation. “This leads to inadequate care for women – both at the time of and after heart attacks – with fatal consequences.”
Figures from the study reveal that about 70,000 women go to the hospital every year in the UK with heart attacks; up to 25,000 of them die.
Researchers estimated that 8,243 of the deaths recorded between 2003 and 2013 could have been avoided in England and Wales had the women received the same quality of care as men.
However, they noted that the true number of lives lost due to unequal care was probably significantly higher, as the study did not include all heart attacks in the UK over the 10-year study period.
As for the cause of the disparity, Gales said that women often do not receive coronary angiographies – video images revealing narrowings or blockages in coronary arteries – immediately when they arrive at the hospital, putting them at a “disadvantage right from the start.” He added that such delays have “knock on effects,” which can create further “shortfalls down the line.”
“In isolation, the differences may appear small, but even in a high-performing health system like the UK, small deficits in care across a population add up to reveal a much larger problem and significant loss of life,” he added.
The study also found that women who had a non-ST-elevation myocardial infarction – a type of heart attack that tends to affect older individuals and carries greater risks – were 34% less likely to receive timely coronary angiographies within 72 hours of their first symptoms.
And women with ST-elevation myocardial Infarctions – a very serious type of heart attack in which the coronary artery is completely blocked – were 2.74% less likely to receive vital treatments, including access to drugs and stent procedures.
The findings of the study were welcomed by Dr. Zachary Whinnett, consultant cardiologist at Imperial College London, who said that ensuring women receive correct treatment will probably lead to improved survival rates.
“Currently, a woman who suffers a heart attack has a higher risk of dying than if she were male. This study found that differences in treatment may be contributing to this increased risk,” he said.
“Although further research is required, this is potentially an important finding because it suggests that the higher risk in women may not just be due to biological differences from men. Ensuring that women who suffer a heart attack receive the correct treatment, without delay, is likely to lead to improved survival.”
Dr. Thomas Owen, research associate at Imperial’s National Heart and Lung Institute, added: “After analyzing a nationwide cohort from 233 hospitals between 2003 and 2013 the authors found disparities in important quality of care indicators, which implies that if women were given the same standard of care as men many lives could have been saved.”
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Researchers at the University of Leeds produced their findings by using data from the UK’s national heart attack registry to evaluate the treatment and outcomes of 691,290 people hospitalized for heart attacks in England and Wales between 2003 and 2013.
The study, however, did not include all hospital admissions over the 10-year period. Women, on average, were also found to be older when admitted to the hospital, and were more likely to have other illnesses, including diabetes and high blood pressure.