Since time immemorial men and women think, behave and speak differently as if both are different species. However, recent evidence suggests that on suffering illness and becoming unwell the two are taken care differently too. This is particularly noticeable as far as cardiac care is concerned. Experts estimate that one in two women will die of heart disease or stroke during their lifetime proving that cardiovascular disease is a major killer of women worldwide. However gender differences persist in diagnosing female patients with heart disease, treating them aggressively and also in the response of the treatment offered to them. In a recent study it was found that in United States 42 percent of women who have heart attacks die within 1 year compared with 24 percent of men. The observed disparities could be due to women having atypical symptoms of heart attack compared to men, patient or physician refusal to recognize the problem, their failure to note the seriousness of the situation along with social and cultural inconsistencies for care of two genders.
His and hers heart disease
Nature has conferred unique age specific protection to women from heart disease. Before they attain menopause, due to protective effect of estrogens, heart disease is less common in them. However the very fact is also partly responsible for the misconception that heart disease primarily affects men. Women also are more likely to have atypical symptoms, contributing to the under-diagnosis of heart disease. Fewer women than men receive pharmacological treatment for heart disease on admission and more women receive anxiolytics, antidepressants, and narcotics. Disparities have also been found in performing both noninvasive tests such as Echocardiography and TMT as well invasive tests such as cardiac catheterization in females. Symptoms in men are addressed with greater earnestness and solemnity. Women with heart attack are more likely to die during the stay in hospital and during the first year following an initial heart attack. This outcome is seen particularly in younger women, especially those younger than 50 years. Women are at increased risk of death, repeat heart attack, heart failure, stroke and the need for transfusion during hospitalization for a heart attack. Thus, clearly there is a sex difference in the utilization of health care services and discrimination in the optimal final outcome for both genders.
Fair correction of the unfairness
Research has suggested that even a normal angiogram in women should be respected as equivalent to that of a heart disease patient and appropriate attention and importance should be given to that.
Perhaps the solution may reside in the upliftment at the social, cultural and moral echelons of the society. Nonetheless greater commitment from the physician community can never be overlooked. Awareness campaigns and efforts to improve female inclusion in clinical trials would also immensely contribute to resolve this disparity.
A proactive approach with women becoming aware of their problems and their pursuance in obtaining health care should be encouraged. It is also time that scientific community takes adequate steps to promote societal change to eliminate gender as a barrier to good health.