Why are men and women treated differently for coronary heart disease (CHD)?

Men and women are treated differently for coronary artery disease (CAD). Women with CAD are at a significant disadvantage compared with men because they do not consistently receive the same intensive, invasive evaluation and treatment as men. Men receive greater access to effective cardiac treatments, including medications and revascularization, while women remain undiagnosed for many years. In a study of 1,254 people (627 men and 627 women) treated for CAD, significantly fewer women received three arterial grafts when compared with men (7.3 percent vs. 10.5 percent). The researchers found no difference in the percentages of bilateral internal thoracic artery and radial artery use between men and women.
Most clinicians assume correctly that women are less likely to receive multiple arterial revascularization, but they tend to believe that this is solely on the basis of a gender bias. This study shows that gender does not play a significant role in this decision. There is no reason that, when adjusted for all risk factors, the degree of multiple arterial revascularization in women should be any different than what men receive.

Women with coronary heart disease (CHD) typically receive less complete surgical revascularization with arterial grafts than men do, but not because of gender bias. Instead, factors such as delayed diagnosis of CHD in women may contribute to the differences in treatment. 
By the time women present with heart disease, they are slightly older and may be facing more comorbidities such as obesity and diabetes. As a consequence, these higher operative risks may preclude women from undergoing the more complex multiple arterial revascularization procedures that men receive.

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