Understanding the gender divide (AHA Scientific Sessions 2006)

Studies find mechanisms for the well-documented gap between outcomes for men and women with heart disease and suggest strategies for narrowing it.

By Victoria Stagg Elliott, AMNews staff. Jan. 1/8, 2007.

Reports from conferences important to physicians

When it comes to heart health, preventive strategies and treatment outcomes, men and women are not the same. Researchers are attempting to quantify the differences and disparities and determine how to address them, according to several studies and panel discussions at the American Heart Assn. Scientific Sessions in Chicago, Nov. 12-15, 2006.

"There's a huge gap in our science and our clinical practice," said Ann Bolger, MD, chair of the AHA's Council on Clinical Cardiology and William Watt Kerr Professor of Clinical Medicine at the University of California, San Francisco. "Women are different from men, and the outcomes, the risk factors and the responses to very particular therapies are probably different. We need to understand this."

These variations seem to start before heart disease becomes apparent. For example, women are less likely than men to be concerned about heart disease risk and to take steps to reduce it. Researchers from the University of Texas Southwestern Medical Center found that women with a family history of heart disease were more likely to smoke, were less active and had more risk factors than men with a similar background.

In the area of primary prevention, recognition is growing that the commonly used Framingham risk assessment tool may not be as good for women -- especially those younger than 70 -- as it is for men. "A majority of women are classified as low risk by traditional risk factor assessment and thus are not considered for more aggressive interventions to prevent the disease that kills the most," said Susan G. Lakoski, MD, a cardiology fellow at Wake Forest University School of Medicine, Winston-Salem, N.C.