Studies Show Treatment Lacking in Women With Heart Disease
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
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
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
McCullough and Allen's findings were presented here at a heart disease
conference sponsored by the American Heart Association and the American College
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
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.
- Researchers report doctors and their female heart disease patients need to
do more to avoid further problems and to recognize when recurrences are
- 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.