Heart attack gender gap is costing women's lives

30 September 2019        

Category: Research

Stark inequalities in awareness, diagnosis and treatment of heart attacks are leading to women needlessly dying every day in the UK, according to a new briefing we've released today.

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The briefing includes BHF-funded research that estimates that more than 8,200 women in England and Wales died over a ten-year period because they did not receive equal treatment to men. The BHF says more lives are at risk as research shows women delay seeking help when they experience heart attack symptoms. 

The charity wants to put an end to the perception that heart attack is a male disease, and is encouraging women to better understand their risk of a heart attack and its symptoms. 

It also says further research is needed to close the heart attack gender gap and will be convening policy makers and healthcare professionals next year about how to address the issues.  

Heart attacks have never been more treatable

Dr Sonya Babu-Narayan, our Associate Medical Director, said:

“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. The studies detailed in this briefing have revealed inequalities at every stage of a woman’s medical journey. The reasons for this are complex to dissect. Together, we must change this.” 

By combining some of the latest evidence with first-hand patient stories, the briefing reveals a concerning picture of women faring worse than men at every stage of their heart attack experience. It shows: 

Unaware: Women often delay seeking medical help, which can reduce their chance of survival. A global systematic review found that the average delay between the onset of symptoms and arrival at hospital for men ranges between 1 hour 24 minutes and 3 hours 30 minutes compared to between 1 hour 48 minutes and 7 hours 12 minutes for women. 

Misdiagnosed:
Research has shown that women are 50 per cent more likely to receive a wrong initial diagnosis when they are having a heart attack. Both men and women who are initially misdiagnosed have a 70 per cent higher risk of dying.   

Substandard treatment:
Over a ten-year period, it is estimated that more than 8,200 heart attack deaths in women in England and Wales could have been prevented if they had received the same standard of care as men. The study found women were less likely to receive standard treatments including bypass surgery and stents.   

Excess risk: Risk factors for heart disease are often more deadly for women. Smoking increases women's heart attack risk up to twice as much as men’s, high blood pressure increases women’s risk 80 per cent more, and type 2 diabetes increases women’s risk 50 per cent more.  

Poorer aftercare: Women often receive poorer aftercare, following a heart attack. A BHF-funded study showed that women in England and Wales were 2.7% less likely to be prescribed statins and 7.4% less likely to be prescribed beta blockers when leaving hospital, despite their proven benefit of lowering the risk of a subsequent heart attack or stroke. 

We can do better

Chris Gale, Professor of Cardiovascular Medicine at the University of Leeds and lead author of some of the studies cited, said: “This problem is not unique to the UK - 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.” 

Despite public misperceptions, twice as many women die from coronary heart disease - the underlying cause of most heart attacks – than breast cancer in the UK. 

Dr Sonya Babu-Narayan added: “The first steps to closing this gender gap include changing the public perception of women and heart attacks. The assumption that women are not at risk of heart attack is false, and has proven to be deadly.”  

“As a starting point, we want to empower women to better understand their risk and to know the many symptoms of a heart attack. When someone has a heart attack – every second counts. The sooner people recognise their symptoms and call 999, the better their chance of recovery. 

“In addition, we need to continue to fund research to better prevent, diagnose and treat heart attacks. We also need to raise national awareness of gender-based inequalities in heart attack care and identify and guard against unconscious biases that could contribute to them.” 
 
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. 

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