- that female patients were less frequently treated with guideline-recommended medications (such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers ARBs) or beta-blockers)
- and that doses were lower in female than in male patients.
Similarly, the dose of ACE inhibitors and ARBs was highest in male patients treated by female physicians and was significantly different from the reverse combination (female patient, male physician). Dosage of beta-blockers was comparable in male patients irrespective of the physician's gender, whereas female patients treated by a male physician received the lowest doses.
The investigators thus concluded that "male patients with chronic heart failure are more likely to receive evidence-based drug treatment than female", particular so for the prescription of ACE inhibitors and dosage of beta-blockers.
The study was an evaluation of 1857 consecutive patients treated at the centres in Germany; treatment records involving 829 physicians (65 per cent general practitioners, 27 per cent internists, and 7 per cent cardiologists) were analysed with regard to evidence-based drug treatments to improve survival. Assessment of dosages was calculated as a percentage of averages documented in treatment guidelines for heart failure.
Commenting on the results, the study's first author Dr Magnus Baumhakel from the University Hospital of the Saarland, Homburg, Germany, said: "The use of evidence-based treatments as described in the latest guidelines has undoubtedly improved the treatment of chronic heart failure. But there is still evidence of a gender imbalance in both patients and physicians. From our results it seems fair to say that the gender of the physician plays an important role in adherence to drug treatment recommendations in chronic heart failure."
This is one of several recent studies to find gender differences in medical care (and survival) in cardiovascular disease. Many have found that women are treated less intensively than men, especially in the acute phase of the disease.
The European Society of Cardiology (ESC):
The ESC represents nearly 53,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
The ESC achieves this through a variety of scientific and educational activities including the coordination of: clinical practice guidelines, education courses and initiatives, pan-European surveys on specific disease areas and the ESC Annual Congress, the largest medical meeting in Europe. The ESC also works closely with the European Commission and WHO to improve health policy in the EU.
The ESC comprises 3 Councils, 5 Associations, 19 Working Groups, 50 National Cardiac Societies and an ESC Fellowship Community (Fellow, FESC; Nurse Fellow, NFESC). For more information on ESC Initiatives, Congresses and Constituent Bodies see www.escardio.org.
European Society of Cardiology, The European Heart House 2035 Route des Colles, B.P. 179 - Les Templiers, Sophia Antipolis F-06903 France
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