Women's heart disease still an issue

WASHINGTON, Jul 05, 2005 (United Press International via COMTEX) -- Heart disease remains the leading cause of death for women, but among hospitals there remains a significant inadequate response to women's cardiovascular disease symptoms.

A study by HealthGrades Inc. in Golden, Colo., a healthcare-quality ratings company, reports many medical professionals are unable to diagnosis women with cardiovascular disease in a timely manner because of symptomatic differences in symptoms between men and women -- a situation that is dangerous to women.

The company's third annual study analyzed women's cardio outcomes from the published data of more than 1,500 hospitals in 17 states -- including California, Iowa, New York and Texas -- representative of 57.9 percent of the U.S. population. It reviewed outcomes of coronary artery bypass graft surgery, valve-replacement surgery and heart failure from 2001 to 2003.

The researchers found 39 percent lower mortality in best-performing hospitals, leaving many of the poorest-performing hospitals behind. They also found American hospitals improved women's survival rates by 11 percent for cardiac disease and stroke between 2001 and 2003.

"Treatment is improving in that women are surviving, but we still have a long way to go," said Dr. Samantha Collier, an author of the study and HealthGrades' vice president of medical affairs. "More women know that cardiovascular disease is one of the first leading causes of death, but still 50 percent of women do not know that."

Heart disease and stroke are the first- and third-leading causes of death among women, Collier said, affecting nearly half of women's death and amounting to almost one death every minute.

"Only a small percentage of women believe that cardiovascular disease is their biggest threat, and only one in five doctors know that CVD kills more women than men each year," Collier said.

She suggested increased awareness in the medical community, adding that women receiving treatment may be dangerously delayed or not receiving high-risk treatment in a timely fashion because of the difference in symptomology.

"We now know that women's average outcomes for cardiovascular care can vary by as much as 46 percent between the best-performing and poorest-performing hospitals," Collier said. "It's important for women to do the research and seek hospitals for the best treatment possible."

Dr. Don Nielsen, senior vice president for quality at the American Hospital Association in Washington, said the study demonstrates the need for a greater awareness of the symptoms peculiar to women vs. men, as well as an awareness of the need to begin timely and appropriate treatment for stroke and heart attack.

Nielsen said that, in the past, most doctors and nurses have treated men for cardiovascular disease based on symptoms such as severe chest pains, but women many times experience atypical symptoms such as pain in the arms and shoulders or excess fatigue.

"We are seeing greater awareness from governmental Web sites and the American Heart Association," he said, about the need to educate women "about risks and symptoms of cardiovascular disease."

A 2004 study by the American Heart Association found awareness of heart-disease symptoms increased to almost 50 percent among women, and respondents reported obtaining most of their information from the mass media instead of a physician. Only 24 percent of the women who responded cited healthcare providers as an information source, while 45 percent cited magazines, 34 percent cited television and 27 percent cited newspapers.

Among other findings in the HealthGrades' study:

--The best-performing hospitals improved by about 12.7 percent in treating women cardiovascular disease patients between 2001 and 2003, while there was a 5.7-percent improvement among the poorest-performing hospitals.

-- The greatest improvement across the board in women's mortality was in CABG surgery, while the least improvement was in stroke treatment.

-- The widest improvement gap between best-performing and poorest-performing hospitals occurred in heart-failure treatment, with best-performing hospitals showing a 23.7-percent improvement, while the poorest performers improved by 4.28 percent.

-- The greatest differences in women's cardiac and stroke outcomes among the best- and poorest-performing hospitals was seen in percutaneous coronary interventions, such as angioplasties, heart failure and CABG.

-- On average, women treated at the best-performing hospitals have a 42.75-percent lower risk of mortality for PCI, a 43.63-percent lower risk of mortality for heart failure and a 46.44-percent lower risk of mortality for CABG.

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Stokely Baksh is an intern for UPI Science News. E-mail: sciencemail@upi.com