Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, March 21, 1994 TAG: 9403210044
SECTION: NATIONAL/INTERNATIONAL PAGE: A1 EDITION: METRO
SOURCE: Fort Lauderdale Sun-Sentinel
DATELINE: LENGTH: Medium
Women sometimes become their own worst enemy, tending to find excuses to delay treatment after heart disease has been diagnosed, physicians and researchers say.
"There is some real discrimination against women when it comes to coronary disease - a real gender bias," said Dr. Fredric Pashkow, director of cardiac rehabilitation at The Cleveland Clinic Foundation in Ohio.
"When I went through my training, I was led to believe coronary artery disease was predominantly a male problem," Pashkow said. "Even though our understanding has grown tremendously over the last few years, a lot of doctors still cling to that erroneous view. And it is costing lives."
According to the American Heart Association, cardiovascular diseases killed 478,179 women in 1990, or 51.6 percent of the 926,079 total deaths in this country from such diseases. In addition, the association reported, 39 percent of women who have heart attacks die within a year, compared with 31 percent of men.
Doctors agree that women tend to get heart disease 10 to 15 years later than men. By age 70, there is an even distribution and equal severity in the two sexes, research has shown. But women who are 70 years old or older are getting far less life-saving surgery.
"If a man and a woman of the same age went to a physician with the same set of symptoms, the physician would be much more likely to suspect that the man has heart disease," said Dr. Julie Buring, an associate professor of ambulatory care and prevention at Harvard Medical School.
Dr. Constance Fields, an interventional cardiologist in Delray Beach, Fla., said both young and old doctors are guilty of failing to consider heart disease in women.
"So many women come to me with bad diagnoses - they have been told they are suffering from stress, or perhaps from a gastrointestinal problem," Fields said.
She said even some cardiologists fail to treat heart problems aggressively.
"I've had nurses tell me, `Dr. Fields, if you weren't on this case, this woman wouldn't have that emergency angiography.' Some male doctors would wait and let the woman experience a heart attack."
Angiography is a procedure that enables blood vessels of chambers of the heart to be seen on film after a contrast medium has been injected into the bloodstream.
Even when significant coronary artery disease is found, women often delay treatment.
"Women are more likely to stall. They often think of excuses," Fields said. "They'd rather take medicine that hopefully would stave off a heart attack - but it won't reverse the disease."
"They cite all kinds of reasons - their father is sick, their daughter is getting married, they can't leave their husband alone. For these women, it is time for a reality check - their life depends on it."
by CNB