Study Finds Gender Bias in Doctors’ Advice to Patients on Heart Disease

Guidelines are the same for both sexes, but evidence suggests women and men get different treatment approaches.

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women told different cardiac advice from doctors
Women were more likely to be advised to lose weight and exercise more, whereas men were more often prescribed statins.Thomas Northcut/iStock

Guidelines for preventing heart disease stress that patients — regardless of sex — should focus on things like good eating and exercise habits, maintaining a healthy weight, and taking medications as needed to lower cholesterol or blood pressure. But a new study suggests that doctors treat men and women very differently.

“Our study found that women are advised to lose weight, exercise, and improve their diet to avoid cardiovascular disease but men are prescribed lipid lowering medication,” said study author Prima Wulandari, MD, of Harvard Medical School and Massachusetts General Hospital in Boston.

“This is despite the fact that guideline recommendations to prevent heart disease are the same for men and women,” Dr. Wulandari said in a statement.

For the study, researchers examined data on 2,984 men and women who participated in the U.S. National Health and Nutrition Examination Study (NHANES) from 2017 to 2020. While none of the participants had a history of cardiovascular disease, they all had at least one risk factor for heart disease, such as diabetes, high blood pressure, high cholesterol, or smoking. And, they all had at least a 1 in 10 chance of experiencing an event like a heart attack or stroke in the next decade.

Adults 45 to 75 years old who fit this profile based on their heart disease risk factors and 10-year risk for heart attacks and strokes should take a low-dose statin drug to lower cholesterol, under guidelines from the U.S. Preventive Services Task Force. Statins are also recommended for these patients, and for some people in their early forties or with a slightly lower 10-year risk of heart attacks and strokes under guidelines from the American Heart Association and the American College of Cardiology?published in March 2019 in Circulation.

None of these guidelines suggest that men and women require different approaches to prevention.

In the new study, however, men were 20 percent more likely to be prescribed statins than women.

Women in the study were also 27 percent more likely to be told to lose weight and 38 percent more likely to be advised to exercise more. Compared with men, women were also 27 percent more likely to be told to reduce their salt intake and 11 percent more likely to be instructed to cut calories or follow a low-fat diet.

Researchers presented these preliminary findings from the study at ESC Asia, a scientific meeting jointly run by the European Society of Cardiology (ESC), the Asian Pacific Society of Cardiology (APSC), and the Asean Federation of Cardiology.

The study wasn’t published in a medical journal, a process that typically involves a review of the findings by independent medical experts. However, the results are in line with a large and growing body of evidence that suggests men and women receive different care for cardiovascular — and that women often have worse outcomes as a result, according to Harvard Health Publishing.

Some previous research also suggests that a potential root of the discrepancy in advice is the misconception that women have a lower risk of cardiovascular disease than men, Wulandari said.

“Our findings highlight the need for greater awareness among health professionals to ensure that both women and men receive the most up-to-date information on how to maintain heart health,” Wulandari added.