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'Unconscious biases' compromise cardiac care for women

Research reveals thousands of women are dying unnecessarily after a heart attack

Mark Gould

Monday, 30 September 2019

Women who suffer heart attacks are dying needlessly because they fail to recognise their symptoms and receive poorer care than men, according to a new report* by the British Heart Foundation (BHF).

Over 10 years, more than 8,000 women in England and Wales died unnecessarily after a heart attack, the report found. And BHF experts say there are inequalities in diagnosis, treatment and aftercare.

"Unconscious biases are limiting the survival chances of women," the report warns.

The report found:

  • women often delayed seeking help
  • they were more likely to receive an incorrect diagnosis and substandard treatment compared to men
  • risk factors, such as smoking and high blood pressure, increase heart attack chances more in women
  • the quality of aftercare was also substandard
  • it found that some commonly held myths - such as heart disease and heart attacks only affecting men - meant women were unaware of their risk, and slow to seek medical help.

There is also a misperception that men and women experience completely different heart attack symptoms, but studies suggest that although symptoms can vary from person to person, chest pain is the most common symptom in both men and women. And younger women do have heart attacks, the report says, which should be taken seriously.

The report makes it clear that there have been significant improvements in how heart attacks are treated. In the 1960s, seven out of 10 heart attacks in the UK proved fatal. Today, seven out of 10 people who have a heart attack will survive.

But Dr Sonya Babu-Narayan, the associate medical director of the BHF, says women are missing out: "Heart attacks have never been more treatable. Yet women are dying needlessly because heart attacks are often seen as a man's disease, and women don't receive the same standard of treatment as men."

She said studies had "revealed inequalities at every stage of a woman's medical journey, and although complex to dissect, they suggest unconscious biases are limiting the survival chances of women".

The BHF report says that each year around 35,000 women are admitted to hospital following a heart attack in the UK each year - an average of 98 women a day, or four per hour. In the UK, women are twice as likely to die from coronary heart disease as from breast cancer.

Chris Gale, professor of cardiovascular medicine at the University of Leeds, led a study which found that thousands of women's lives were needlessly lost in England and Wales after heart attacks, between 2002 and 2013.

"This problem is not unique to the UK," he said.

"Studies across the globe have also revealed gender gaps in treatment, suggesting this is a deeply entrenched and complex issue.

"On their own, the differences in care are very small, but when we look at this across the population of the UK, it adds up to a significant loss of life.

"We can do better."


*Bias and Biology. A British Heart Foundation briefing, September 2019.

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