Gender Difference or Gender Bias?
Often, people want to know if womens' health risk is due to gender
difference or gender bias? The answer is: probably some of both.
Several factors may explain the apparent disparity
in treatment of men and women:
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In the past, many of the major cardiovascular
research studies were conducted on men. Results of clinical studies
currently under way may help clarify the gender differences that affect
diagnosis and treatment of women with heart disease.
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Clinicians and patients often attribute
chest pains in women to non-cardiac causes, leading to misinterpretation
of their condition.
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Both women and men may present with "classic"
chest pain that grips the chest and spreads to the shoulders, neck,
or arms. Women may have a greater tendency to have atypical chest
pain or to complain of abdominal pain, difficulty breathing (dyspnea),
nausea, and unexplained fatigue.
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Women may avoid or delay seeking medical
care, perhaps out of denial or not being aware of both typical and
atypical heart attack symptoms.
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Since women tend to have heart attacks
later in life than men do, they often have other conditions (such
as arthritis or osteoporosis) that can mask heart attack symptoms.
Increased age and the more advanced stage of coronary heart disease
in women can affect treatment options available to physicians. Increased
age can also help explain women's greater mortality after heart attacks.
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Some diagnostic tests and procedures may
not be as accurate in women, so physicians may avoid using them. That
means the disease process resulting in a heart attack or stroke may
not be detected in women until later, with more serious consequences.
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The exercise stress test, or stress ECG,
may be less accurate in women. For example, in young women with a
low likelihood of coronary heart disease, an exercise stress test
may give a false positive result. In contrast, single-vessel heart
disease, which is more common in women than in men, may not be picked
up on a routine exercise stress test. More precise noninvasive and
less invasive diagnostic tests tend to cost more. These include thallium,
sestamibi, or echocardiographic stress tests.
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CONTENT SOURCE: www.americanheart.org
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