Women under age 55 are significantly less likely to be on optimal therapy 1 year after a heart attack compared with male heart attack survivors of the same age, according to a study published online October 13, 2015 in Circulation: Cardiovascular Quality and Outcomes.
“There are two possible reasons why women take fewer cardiovascular medications than men in an outpatient setting,” said lead author of the study Kate Smolina, PhD, postdoctoral fellow in pharmacoepidemiology and pharmaceutical policy at the Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada. “It is either a consequence of physicians’ prescribing behavior, or patients not taking their prescribed medication, or both.”
In this retrospective population-based study, researchers analyzed data on more than 12,000 patients who were admitted to hospitals for acute myocardial infarction (AMI) between 2007 and 2009 in British Colombia, Canada, and survived for at least 1 year. Researchers determined whether patients initiated and then filled prescriptions for angiotensin converting enzyme inhibitors, beta blockers, and statins.
Numerous other studies have consistently demonstrated that women are less likely than men to receive appropriate pharmacotherapy during hospitalization for AMI or at discharge. This study, which was focused on outpatient settings, found that 65% of women under age 55 initiated their treatment on all appropriate drugs after a heart attack, compared with 75% of same-aged men.
“The gender gap in treatment initiation among younger women is an important finding because younger women have much worse outcomes after suffering a heart attack than do men of the same age,” said study co-author Karin Humphries, MBA, DSc, associate professor of Cardiology at the University of British Columbia. “This finding suggests that younger women should be treated aggressively, especially when we have medications that work.”
Researchers could not clearly determine whether gender-based differences in treatment initiation were driven by physician prescribing practices or by patient behavior. But, either way, more focus is needed on treating young women after a heart attack, they said.
“It is important for both physicians and patients to move away from the traditional thinking that heart disease is a man’s disease,” Dr. Smolina said. “Heart disease in young women has only recently received research attention, so it is possible that physicians and patients still have the incorrect perception that these heart medications pose risks to younger women.”
Another important finding from this study: Only one third of all heart attack survivors (both men and women) filled all of the appropriate prescriptions for at least 80% of the year.
“Overall, the majority of AMI survivors either discontinue treatment or do not refill their prescriptions consistently, suggesting that further improvements in post-AMI therapy management are necessary,” the authors concluded.