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Researchers at the School of Public Health have found that women hospitalized for heart attacks are approximately 40 percent more likely to die than men hospitalized for the same condition. This is one of several important gender differences found in a national study of more than 6,000 adults age 70 and older. The study was based on interviews and analysis of Medicare claims from 1984 to 1991.
The nationwide study also found that when compared with other patients who were re-hospitalized for various reasons during the study period, women heart attack patients had more episodes, incurred greater hospital charges and were in the hospital longer.
Dr. Fredric Wolinsky, professor of health services research at the School of Public Health and lead author of the study, said there are two main reasons for the discrepancies, both of which reflect gender differences in the underlying socialization processes. One involves a patient's recognition of symptoms, such as chest pain and dizziness, and the knowledge that these symptoms signal a heart attack.
"Men are somewhat more likely to make these connections and to make them sooner than women," Wolinsky said. "As a result, women are more likely to delay seeking treatment. They arrive at the emergency room later and in worse shape."
Wolinsky said the second reason for the gender differences involves the socialization of physicians.
"There is evidence to suggest that health care professionals are quicker to diagnose men with heart attacks than women and to treat men more aggressively," Wolinsky said.
An estimated half-million Americans die of heart attacks each year. Previous studies have found that women are more likely to die than men, but Wolinsky's study is significant because it is one of the largest community-based studies of these gender differences, and because it focuses on older adults. Nearly 85 percent of heart attack deaths involve individuals 65 and older. This also is the first study to look at gender differences in regard to re-hospitalization rates, total costs and lengths of stay.
In the absence of any known biological reason to explain these gender differences, Wolinsky said that researchers have to conclude that the reason women are more likely than men to die from heart attacks relates to prevention and diagnosis.
"Therefore, the take-home message from this study is that increased primary prevention, diagnosis and treatment efforts should be directed toward women," he said.
Wolinsky's article appears in the February issue of the Journal of the American Geriatrics Society. His co-authors are Kathleen Wyrwich and Dr. James Gurney.
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