Despite campaigns to educate women and doctors about heart disease, a study of insurance claims shows women get fewer aggressive treatments after a heart attack than men.
The Blue Cross Blue Shield Association examined 2014 medical claims and found that women are 27 percent less likely than men to get angioplasties to open clogged arteries and are 38 percent less likely to undergo coronary bypass surgery.
While the report released Tuesday presents only a one-year snapshot, “it’s scary data,” said Dr. Marla Mendelson, medical director of the program for women’s cardiovascular health at Northwestern Medicine in Chicago.
She is concerned because Blue Cross’ findings echo one of the first reports examining the differences in cardiac care broken down by gender. That study was published in July 1991.
“We’ve been grappling with this for more than 20 years,” Mendelson said. “We’ve not come a long way, baby.”
Heart disease is the No. 1 killer of women in the U.S. and is more deadly than all forms of cancer combined, according to the American Heart Association. Nearly 400,000 women died of cardiovascular disease in 2013, the most recent data available. Since 1984, more women than men have died each year from heart disease.
But when it comes to diagnosing and treating the condition, there is a gender gap. Blue Cross’ report doesn’t attempt to explain the disparities in post-heart attack treatment.
Scientific literature suggests that both biology and unintended bias in disease management may be at play, said Dr. Trent Haywood, chief medical officer at the Chicago-based Blue Cross association.
Medical research had historically neglected the health needs of women, apart from reproductive concerns. It wasn’t until 1990 that the federal government established a research initiative on women’s health at the National Institutes of Health.
Starting in 2000, there has been a big improvement in cardiovascular disease mortality rates for women. Researchers credit improved therapies and better preventive care, which likely resulted from more attention on heart disease in women.
For more than a decade, programs have worked to raise awareness about women’s risk of heart disease, including “Go Red for Women” by the American Heart Association. But only 54 percent of women recognize that heart disease is their leading cause of death, according to the Centers for Disease Control and Prevention.
Mendelson applauded Blue Cross for its research. The association, a federation of 36 independently operated Blue Cross and Blue Shield companies, analyzed data for members age 18 to 64.
“This is a good thing for insurance companies to do because they have access to so much data and can turn around and educate women about this,” she said.
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The study also revealed that heart attacks occur more frequently in men than in women, a finding consistent with CDC statistics.
Heart attack rates also vary considerably across the country. The study found that states with high heart attack rates also tend to exceed the national average rates for at least two of three risk factors: physical inactivity, obesity and smoking.
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