Women appear less likely than men to take all the medications needed after a heart attack to help prevent repeat episodes, a Canadian study suggests.
Researchers analysed data on more than 12,000 patients who survived for at least a year after a heart attack between 2007 and 2009. They found that women were just as likely as men to stick with prescribed drugs to lower cholesterol and blood pressure once they started.
The trouble is that women were less likely than men to start taking all of the drugs recommended for heart attack survivors.
While the study can’t determine the exact reason for the gender gap — doctors might not have prescribed the drugs or women might not have filled the prescriptions — the findings highlight the need to offer women more aggressive treatment, said lead study author Kate Smolina.
“It is important for both clinicians and patients to move away from the traditional thinking that cardiovascular disease is a man’s disease,” Smolina, a researcher at the University of British Columbia, said by e-mail.
The gender gap persisted for all age groups but was particularly stark for younger patients, Smolina and colleagues report in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.
Among heart attack patients under 55, only 65 per cent of women initiated treatment with all appropriate drugs, compared to 75 per cent of men that age, the study found.
For the oldest patients in the study, people over 85, drug compliance was generally worse but the gender disparity wasn’t as pronounced. At this age, 50 per cent of men and 48 per cent of women initiated appropriate medication therapy.
Once they filled prescriptions, however, sticking to medications was similar for men and women one year after they left the hospital, the study found.
“Younger women should be treated just as aggressively as older women or as men of the same age, especially when we have medications that work,” Smolina said.
The prescriptions assessed were for medicines designed to help lower cholesterol and blood pressure, which are both linked to a lower risk of repeat heart attacks.
Overall, more than two thirds of the heart attack survivors in the study initiated treatment on all appropriate medications within two months of leaving the hospital.
Over the next year, however, only one third of them filled these prescriptions at least 80 per cent of the time.
One limitation of the study is that it relied on prescription data to assess how often patients took recommended medications, a measure that can’t capture when or if doctors prescribed medicines or how long patients might have waited to fill those prescriptions, the researchers acknowledge.
Previous research has shown women, particularly younger women, are less likely than men to receive recommended therapies after a heart attack, noted Dr Gregg Fonarow, co-director of preventive cardiology at the David Geffen School of Medicine at the University of California, Los Angeles.
“This study confirms those prior findings but shows once started on post [heart attack] medications, women were just as likely to continue therapy through the first year,” Fonarow, who wasn’t involved in the study, said by e-mail. “This suggests the differences in initial outpatient use reflects differences in therapies being prescribed at discharge from the hospital.”
