A mistaken belief that coronary heart disease (CHD) affects only middle-aged men could be the reason why both women and younger people with the disease are not receiving optimal care, say the authors of a new study into Australian general practice care.
The large-scale analysis carried out by La Trobe University researchers and published in Heart found that many Australians living with CHD are under-prescribed recommended medications, are not monitored for major risk factors and have treatments that do not achieve recommended goals. In particular, women and those aged less than 45 years were more likely to be under-treated compared with similarly affected men and older people.
The study, led by La Trobe epidemiologist Professor Rachel Huxley, analysed GP records of 130,926 patients with a history of CHD from 2014-2018. Findings included:
- Women were less likely than men to be prescribed with any of the four recommended medications for CHD, namely antiplatelet agents, ACE inhibitors, beta-blockers and statins
- Of the four medications recommended for daily use, only about 22 per cent of women and 34 per cent of men were prescribed all four
- In contrast, 21 per cent of women and 10 per cent of men were not prescribed any of these four medications
According to Australian Institute of Health and Welfare figures for 2015, 44 per cent of all deaths from CHD are women, and CHD remains a leading cause of death among women in Australia.
“There’s a widely-held assumption that CHD only affects older men, but almost half of people who die from the disease are women,” Professor Huxley said.
“Our study shows that people with a history of CHD, particularly women and people aged less than 45 years, are less likely to have their condition managed according to current clinical guidelines. Despite the differences in CHD management, women were more likely to achieve treatment targets than men.”
Professor Huxley said sex disparities in the management of CHD in primary practice needed addressing to improve the outcomes for all affected people and their families.
The National Heart Foundation welcomed the latest findings. The Foundation’s Director of Prevention, Ms Julie Anne Mitchell, said research consistently highlighted that women were “invisible when it comes to heart disease”.
“Heart health checks, lifestyle changes and appropriate medications are just as important for women as they are for men, and these findings challenge all clinicians to keep this in mind when assessing patients,” Ms Mitchell said.
“Australian research highlights that total healthcare spending on women with heart disease is less than half of that spent on men, and this latest research shows yet again why we need to redress the imbalance,” she said.
The research was funded by a National Heart Foundation of Australia Vanguard Grant, with data accessed from Medicine Insight, a national GP data program.