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Heart Attack Care Continues To Be Biased In Favor Of Men

rses that included a pledge to stick to treatment and follow-up appointments, had a 54 percent lower risk of dying within a year than those who didn't.

"We're troubled by the gender differences we found, though we remain encouraged by the overall effect of post-heart attack quality improvement efforts," says senior author Kim Eagle, M.D., co-director of the U-M Cardiovascular Center and the Hewlett Professor of Medicine at the U-M Medical School. Eagle co-directs the Guidelines Applied in Practice (GAP) Project in Michigan, the ACC program under which the study was performed.

While the reasons behind the persistent differences are unclear, Eagle and his colleagues speculate that it may have something to do with the fact that women heart attack patients tend to be older, and as a result doctors may not feel that women patients can derive as much benefit from post-heart attack treatments and lifestyle changes.

Indeed, the study participants were 48 percent women, but the women on average were five years older than the average for men. But Eagle notes that the results of the study fly in the face of perceptions about older women and treatment benefits; even the older women in the study had a much lower risk of dying after hospitalization if they had received high-quality treatment and a pre-discharge counseling session.

Previously, Eagle and his colleagues have shown that GAP reduced patients' risk of dying within a year of leaving the hospital by 25 percent, if doctors and nurses followed standard national guidelines for their care, and used the discharge tool and contract. This major effect on mortality rates was the first evidence that standardized heart care saves lives.

GAP tries to increase hospitals' use of aspirin and beta blocker drugs, and cholesterol testing, within 24 hours of a heart attack, and the prescribing of aspirin, beta blockers, cholesterol-lowering drugs and ACE inhibitor drugs for patients l
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