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Perspectives

Gender bias in cardiology: are there differences between men and women?

Lesley V Campbell, Berit Lilienthal Heitmann

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Abstract

Women are more likely to die of heart disease than men, yet are often underdiagnosed and presented with fewer management options and their treatment may result in greater complications. The reasons may include physiological differences between the sexes, a lack of physician knowledge and unconscious gender bias.

Key Points

  • Women are at least five times more likely to die of heart disease than men.
  • Differences in presentation can make diagnosis of heart disease in women more difficult.
  • The Framingham risk score underestimates cardiac risk in women.
  • Women at higher risk of CVD are treated with fewer therapeutic interventions; they are treated suboptimally with medication, catheterisation and revascularisation.
  • Cardiac symptoms may have a different physiological basis in women.

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