Atrial fibrillation (AF) is an irregular heart rhythm that raises a person’s risk of stroke. Previous studies have found that women are at increased risk of AF-related stroke compared to men. In addition to atrial fibrillation, research has also suggested that women are at increased risk of stroke if they have another risk factor, such as older age, high blood pressure or diabetes.
Canadian researchers recently analyzed health records for more than 350,000 people diagnosed with AF, 49 percent of whom were women. They found that differences in cardiovascular care may raise the risk of stroke in women with AF compared to men.
Women may not receive treatment for AF at the same rate as men because of both provider- and patient-related factors, the senior author on the study, Husam Abdel-Qadir, told TheDoctor.
Among providers, the idea persists that heart disease and stroke are men’s diseases, even though that is not true. This bias may influence primary care providers’ decisions to refer patients to a cardiologist, run tests or prescribe medications to reduce the risk of heart disease. As Abdel-Qadir, a cardiologist at Women’s College Hospital and the Peter Munk Cardiac Centre in Toronto said, “If you think the risk is low, you are going to do less about it.”
The fact that women had to go to the emergency room to get diagnosed for the first time suggests they are less likely than men to have atrial fibrillation caught early.
Women were more likely to be diagnosed with AF in the emergency room and receive fewer cardiologist appointments in the year before and the year after diagnosis than men.
These findings surprised Abdel-Qadir. “I would have thought that because women have a higher risk of stroke than men, the rates of seeing a cardiologist would be similar,” he said.
The fact that women had to go to the emergency room to get diagnosed for the first time suggests they are less likely than men to have AF caught early, he added. It could also mean they have more severe symptoms by the time they are diagnosed with AF. “Either way, they should be seeing a cardiologist at the same rate as men,” said Abdel-Qadir.
Women were also less likely to have their “bad” cholesterol or low-density lipoprotein (LDL) cholesterol levels checked and be prescribed statins, even though their LDL levels and blood pressure were higher than those of men.
Some of the disparities may be influenced by income and socioeconomic status, which are associated with the likelihood of seeking healthcare or the ability to access care. According to the data used for the current analysis, women more often than men live in lower-income neighborhoods, making them less likely to seek care.
The study is published in the European Heart Journal.