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Studies Show Treatment Lacking in Women With Heart Disease

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WebMD Health News

April 10, 2000 (Washington) -- Americans don't seem to be picking up much speed on the long road to the end of heart disease in women. Even after bypass surgery, women aren't doing as well as they should in managing risk factors that contribute to heart disease, according to a new study presented Monday. A second study shows that women suffering from heart failure are less likely than men to be tested for a key sign of the disease.

These disturbing findings suggest that both physicians and their female patients could do a better job of diagnosing and preventing the recurrence of heart disease. "Clearly, the message is that these women were not being managed appropriately in terms of their heart disease risk factors," says Jerilyn Allen, ScD, RN, of the Johns Hopkins University School of Nursing in Baltimore.

Allen followed 130 women for one year after bypass surgery. Despite their heart disease and surgery, the women continued to engage in a number of risky behaviors -- 58% were obese, 54% had high blood pressure, 92% weren't reducing high cholesterol levels, and 10% were still smoking.

Meanwhile, Peter McCullough, MD, a preventive cardiologist at the Henry Ford Heart and Vascular Institute in Detroit, looked at how more than 3,300 patients with heart failure were being treated in an HMO environment. He found that while women were getting more exams for thyroid problems that could lead to heart failure, they were not being tested for ischemia, a hallmark of the disease in which the heart becomes starved for oxygen. The research shows that 45% of the men were studied for ischemia, compared to just 35% of the women.

Acknowledging that heart failure can be a tough call, McCullough offers this advice: "The scientific community really needs to have an all-out effort to include women equally, if not more so than men, in clinical trials of heart failure."

McCullough and Allen's findings were presented here at a heart disease conference sponsored by the American Heart Association and the American College of Cardiology.

So who's to blame for these life-threatening statistics? "From my perspective, it's a shared responsibility [between doctors and patients]," says Allen. "A lot of it also has to do with our inadequate system of care in terms of follow up," she adds.

For now, Allen says that based on her study, women don't do as well after bypass surgery as men. However, she says, the traumatic experience of bypass offers patients "teachable moments ... they don't ever want to go through this again."

Lynn Smaha, MD, president of the American Heart Association, tells WebMD that barriers to quality care exist on all fronts. "[Y]ou can't put the blame necessarily on the practitioners, or on the system, or on the patients. It's all of the above, plus many other things," he says.

Vital Information:

 

  • Researchers report doctors and their female heart disease patients need to do more to avoid further problems and to recognize when recurrences are happening.
  • One study showed doctors did a better job of looking for evidence of oxygen-starved heart muscle, or ischemia, in male patients than in female patients with heart failure. Also, in a group of women who underwent heart bypass surgery, nearly 60% were still obese and more than half had high blood pressure one year after surgery.
  • Observers note patients, doctors, and the health care system share the blame for these shortcomings in fighting heart disease in women, along with many other factors.

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