Women less likely to be prescribed post-heart attack drugs, researchers find

They are less likely to initiate treatment, but once therapy starts there is no sex difference in staying with treatment.  

“This is very helpful because it identifies the point on the continuum of care at which the disparity occurs and where we need to focus interventions​,” said Kate Smolina​, lead author of the study​ and postdoctoral fellow at the Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada

Male and female heart attack survivors should take ACE inhibitors, beta-blockers and statins to prevent another heart attack, but previous studies had recorded lower medication use among women than men. 

The new study looked at more than 12,000 heart attack patients that survived for at least a year in British Columbia, Canada.  It found that only one-third of all heart attack survivors filled all the appropriate prescriptions for at least 80 percent of the year.

Just 65% of women under age 55 started on all appropriate drugs after a heart attack, compared to 75% for men.  Both men and women tended to continue or drop out of therapy at the same rates. There were no notable differences between the difference drug classes – the sex disparity was present for all.

“The drivers behind sex disparity in treatment are still not well understood, and it is likely to be a multi-factorial phenomenon​,” Smolina noted. 

The research was published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.​

There is no obvious quick-fix solution and future research should aim at understanding the phenomenon.  The study was unable to determine whether differences were driven by physician prescribing behavior or patient behavior. 

“It is important for both clinicians and patients to move away from the traditional thinking that cardiovascular disease is a man’s disease, influencing perception of risk of a recurrent event or death, especially at a young age​,” added Smolina.

Younger women [under 55] tend to have worse outcomes than men of the same age. Therefore, younger women should be treated just as aggressively as older women or as men of the same age, especially since there are medications that work. 

“Awareness and education of healthcare professionals about this sex disparity in treatment is an important first step​,” says Smolina. “Recognition of younger women as an under-treated subgroup should be incorporated into physician education. Because this disparity is likely a result of multiple factors at play, there is no obvious quick-fix solution​.”