Women 'losing out' on heart care

Emergency care for female heart failure patients lags behind that offered to men, a UK-wide survey shows.

Researchers found female patients were less likely to receive recommended investigations such as ultrasound scans and drug treatment, like beta blockers.

They were also less likely to be given treatment to prevent worsening of their symptoms when they left hospital.

The study, to be published in the journal Heart, is based on a survey of almost 9,500 emergency admissions.

Researcher Professor Martin Cowie, from Imperial College London, said: "Women are getting a worse deal than their male counterparts. There is a general perception, both among women themselves and the doctors that look after them that women are less likely to have heart problems, and if they do they are less likely to be as serious as they are in a man."

However, Professor Cowie said the evidence suggested that the risk was similar for both sexes. "Symptoms in a woman need to be taken just as seriously, and treated just as aggressively as they would be in a man," he said.

Overall, the results show heart failure care has improved. But while hospital stays have shortened, deaths from heart failure remain high. One in seven (15%) of patients died while in hospital. Only 14% of patients in the survey were transferred to the care of a heart specialist. And few patients, irrespective of gender, received all the appropriate recommended care once they had left hospital.

Only one in five were given an appointment with a specialist to monitor their progress, and less than 1% were referred to rehabilitation or specialist palliative care. Heart failure means that insufficient blood is pumped around the body to meet the needs of the tissues.

It is caused by blocked arteries, a past heart attack which has done some damage to the heart muscle or heart defects present since birth. It is likely to pose an increasing problem for the NHS as the population ages and treatment for, and survival from, coronary heart disease continues to improve.

But writing in the journal, the researchers warn: "Whereas [heart attack], angina and arrhythmia services have clearly defined targets and have been the focus for sustained investment, heart failure still appears to be regarded as a Cinderella subspecialty, despite its ubiquitous nature."

Professor Peter Weissberg, medical director at the British Heart Foundation, said treatment of heart failure patients needed "urgent attention". He said: "Many people living with heart failure are not receiving adequate assessment and optimum care. Women tend to develop heart failure later than men, which may explain why their passage through the health service is different. However, medical decisions based primarily on gender or age and not on clinical effectiveness have no place in a 21st century NHS."

A Department of Health spokesperson said the new GP contract had already had a major impact on improving diagnosis and management of heart failure, and an audit of services would aid progress.

"Heart failure is mainly a disease of older people. As women continue to live longer than men, more of them are presenting with heart disease. It is important that health services recognise this, and ensure that men and women alike receive treatment in line with best practice."