A new European survey of doctors reveals a glaring blind spot when it comes to watching out for female patients’ heart health.
French researchers sent out a questionnaire to 52 general practitioners (GPs). They also obtained access to the medical histories of more than 2,000 of their randomly selected patients. But when they tried to use these records to estimate the patients’ future risk of heart disease using two common screening scales, they noticed a persistent pattern: Charts belonging to women were less likely to have enough information on risk factors to conclude much of anything.
“GPs were less likely to collect information on smoking, blood glucose, and cholesterol in female patients, making it impossible to assess their cardiovascular risk,” said lead author Dr. Raphaëlle Delpech, herself a GP at the University of Paris-Sud, in a statement. “Guidelines recommend screening for cardiovascular risk factors in men and women, but it appears that GPs are more attentive to these factors in their male patients.”
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Overall, Delpech and her team found that they were able to pinpoint a woman’s level of risk 36 to 37 percent less often than they could with a man. Tellingly, the information gap was wider in female patients who saw a male GP as opposed to one of the same gender, though it was still present. For women who saw a male GP, the researchers could assess risk 44 percent less often by one measure; for those in the latter group, it was 28 percent less often.
“The patients who were least well assessed for cardiovascular risk were women seen by male GPs,” said Delpech. “We think that female GPs follow guidelines more routinely and are less likely to vary their practice, especially according to their patients’ gender.”
Disheartening as this trend might be, it does make a sort of sense, according to Delpech. Men are traditionally at greater risk of cardiovascular disease than women, largely because they’re more likely to smoke or have a poor diet, and the condition may affect both genders differently. But other research has shown the price of assumption: Women are less likely to recognize the signs of a heart attack and other cardiovascular diseases when they show up. And they are also less likely to receive proper preventive carefollowing their first bout of cardiovascular disease — a fact that inspired Delpech’s attempt to look at early prevention in the first place.
These disparities can obviously lead to delayed care and worse outcomes for women. And may also explain why the successful effort to drive down deaths from cardiovascular disease globally is more pronounced among men. Removing these blinders, then, will prove crucial to continuing the fight against the chronic condition, Delpech noted.
“I think most GPs will be surprised by our findings, and I hope this will help them ensure they assess cardiovascular risk equally in their male and female patients,” she said. “A government media campaign aimed at physicians could help raise awareness and stimulate change. Another possibility would be introducing performance-related pay for GPs based on their assessment of patients’ cardiovascular risk.”
Source: Delpech R, Ringa V, Falcoff H, et al. P rimary Prevention Of Cardiovascular Disease: More Patient Gender-Based Differences In Risk Evaluation Among Male General Practitioners. European Journal of Preventive Cardiology. 2016.
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