HEART ATTACKS: Bias Exists in Care for Female Patients

      Female heart attack patients receive "somewhat less-aggressive" treatment than male patients, but both generally survive at equal rates, despite the gap in care, according to researchers at Swedish Medical Center in Seattle. Their study, published in today's New England Journal of Medicine, tracked 139,000 Medicare patients who had heart attacks in 1994 or 1995. The researchers found that women were 7% less likely than men to receive thrombolytic drugs during the first hour of treatment; 3% less likely to be given such medication over the course of their hospital stay; 6% less likely to receive aspirin in the first 24 hours of hospital care and more inclined to have a "do-not-resuscitate" order in their records. Female patients also received fewer catheterizations to determine if angioplasty was necessary -- a statistical difference that was considered "particularly striking" among women ages 85 years and older. Women, however, were as likely as men to receive beta-blockers and more likely to get ACE inhibitors (Zimmerman, Wall Street Journal, 7/6).

Healthy Habits Pay
      An unrelated study also published in today's New England Journal of Medicine concludes that women can lower their risk of heart disease by up to 83% when following lifestyle guidelines that include a healthy diet, moderate physical exercise, not smoking and limited alcohol consumption, according to research led by a Harvard School of Public Health physician. The "surprising" results are based on data from 84,129 female RNs who were followed for 14 years as part of the ongoing Nurses' Health Study at Brigham and Women's Hospital. Researchers found that women with the lowest risk for heart disease were nonsmokers who exercised at least 30 minutes per day, were not overweight and consumed an average of half an alcoholic beverage per day. Women with these characteristics were in the top 40% of the group in terms of a healthful diet. Researchers found cigarette smoking was the most important individual risk factor: women who smoked 15 or more cigarettes per day were more than five times more likely to suffer heart attacks than women who never smoked. Experts said the study is important because it focuses on behaviors that women can modify themselves, rather than costly drugs and medical care that may cause side effects (Powell, Los Angeles Times, 6/6).