Gender variation in clinical decision-making was measured, including (1) the number, types, and certainty levels of diagnoses considered and (2) how diagnoses vary according to patient characteristics, when patients have identical symptoms of CHD (Maserejian et al., 2009).
This was a factorial experiment presenting videotaped CHD symptoms, systematically altering patient gender, age, socioeconomic status (SES) and race, and physician gender and level of experience. The primary end point was physicians' most certain diagnosis. The results: Physicians (n=128) mentioned five diagnoses on average, most commonly heart, gastrointestinal, and mental health conditions. Physicians were significantly less certain of the underlying cause of symptoms among female patients regardless of age, but only among middle-aged women were they significantly less certain of the CHD diagnosis. Among middle-aged women, 31.3% received a mental health condition as the most certain diagnosis, compared with 15.6% of their male counterparts. An interaction effect showed that females with high SES were most likely to receive a mental health diagnosis as the most certain.
Middle-aged female patients were diagnosed with the least confidence, whether for CHD or non- CHD conditions, indicating that their gender and age combination misled physicians, particularly toward mental health alternative diagnoses. Physicians should be aware of the potential for psychological symptoms to erroneously take a central role in the diagnosis of younger women.
Innate differences in gender physiology result in unique exposures, risk, and protection that are specific to women. Recognition and appreciation of these differences results in better treatment adaptations for women and better outcomes. Disparities between genders in the treatment of major cardiovascular risk factors still exist and are mostly secondary to underestimating or misunderstanding a woman's risk. Preventive therapies are less often recommended to women. Women are more likely to be diagnosed and treated for hypertension, but are less likely to reach treatment goals. Through understanding these disparities, health care providers will be better able to screen female patients and institute evidence-based therapies for the prevention of cardiovascular disease (Jarvie & Foody, 2010).
Level of Evidence
Shirato and Swan, 2010
Nancy N. Maserejian, Carol L. Link, Karen L. Lutfey, Lisa D. Marceau, and John B. McKinlay, 2009
By Holli a. DeVon, RN, PhD, Catherine J. Ryan, RN, PhD, APRN, CCRN, Amy L. Ochs, BSN, and Moshe Shapiro, MS, 2008
Gisele S. Silva, Fabricio O. Lima, Erica C.S. Camargo, Wade S. Smith, Michael H. Lev, Gordon J. Harris, Elkan F. Halpern, Walter Koroshetz, and Karen L. Furie, 2010
Borejda Xhyheri and Raffaele Bugiardini, 2010
Vlassis N. Pyrgakis, 2010
Jerome Roncalli, Meyer Elbaza, Nicolas Dumonteila, Nicolas Boudoua, Olivier Laireza, Thibault Lhermusiera, Talia Chilona, Cecile Baixasa, Michel Galinier, Jacques Puela,, Jean-Marie Fauvela, Didier Carriea, Jean-Bernard Ruidavetsc, 2010
Chiara Melloni, Jeffrey S. Berger, Tracy Y. Wang, Funda Gunes, Amanda Stebbins, Karen S. Pieper, Rowena J. Dolor, Pamela S. Douglas, Daniel B. Mark, L. Kristin Newby, 2010
Chiara Melloni, Kristi Newby, 2009
Alice K. Jacobs, 2009
Ann F. Chou, Sarah Hudson Scholle, Carol S. Weisman, Arlene S. Bierman, Rosaly Correa-de-Araujo, and Lori Mosca 2007
Jennifer L. Jarvie & JoAnne M. Foody, 2010
Nina P. Paynter, Daniel I. Chasman, Guillaume Pare, Julie E. Buring, Nancy R. Cook, Joseph P. Miletich, and Paul M. Ridker, 2010
Krantz, M. Olson, J. Francis, C. Phankao, N.B. Merz, G. Sopko, D. Vido,
L.J. Shaw, D.S. Sheps, C. Pepine, K. Matthews and Wise Investigators, 2006
Main Points Scanned, Organized and Categorized
Multiple factors contribute to more cardiovascular complications in women. Women present atypical symptoms and are affected later in life relative to men.
Women relative to men have a greater risk of mortality from cardiovascular...
The differences in patterns of care demonstrate the need for interventions tailored to address gender disparities
Gender and age combinations mislead physicians particularly toward mental health diagnosis alternatives.
Randomized Clinical Trial
Regular use of low-dose aspirin may reduce the risk of MI in women.
Women are less likely to achieve independence after acute ischemic stroke.
Research suggests several gaps in knowledge related to the prevention of cardiovascular disease must be addressed to optimize the cardiovascular health of women.
Enrollment of women in randomized clinical trials has increased over time but remains low relative to their overall representation in disease populations. Efforts are needed to reach a level of representation that is adequate to ensure evidence-based sex-specific recommendations.
Chou, Anne F., Sarah Hudson Scholle, Carol S. Weisman, Arlene S. Bierman, Rosaly
Correa-de-Araujo, & Lori Mosca (2007). "Gender Disparities in the Quality of Cardiovascular Disease Care in Private Managed Care Plans." In Women's Health
Issues 17: 120 -- 130.
DeVon, H., Ryan, C.J., Ochs, a.L., & Shapiro, M. (2008). "Symptoms Across the Continuum of Acute Coronary Syndromes: Differences Between Women and Men." In Am J. Crit Care 17:14-24.
Jacobs, Alice K. (2009). "Coronary Intervention in 2009: Are Women No Different Than
Men?" In Circ Cardiovasc Interv 2:69-78.
Jarvie, J.L. & Foody, J.M. (2010). "Recognizing and Improving Health Care
Disparities in the Prevention of Cardiovascular Disease in Women." In Curr
Cardiol Rep 12:488 -- 496.
Krantz, D.M. Olson, J. Francis, C. Phankao, N.B. Merz, G. Sopko, D. Vido,
L.J. Shaw, D.S. Sheps, C. Pepine, K. Matthews & Wise Investigators (2006).
"Anger, Hostility, and Cardiac Symptoms in Women with Suspected Coronary
Artery Disease: The Women's Ischemia Syndrome Evaluation (WISE) Study." in
Journal of Women's Health 15: 1214-1223.
Maserejian, Nancy J., Carol L. Link, Karen L. Lutfey, Lisa D. Marceau & John B.
McKinlay (2009). "Disparities in Physicians' Interpretations of Heart Disease
Symptoms by Patient Gender: Results of a Video Vignette Factorial Experiment."
In Journal of Women's Health 18: 1661-1667.
Melloni, Chiara & Kristi Newby (2009). "Sex Differences in Medical Care After Acute
Myocardial Infarction: what can be done to address the problem." In Women's
Health 5: 339-341.
Melloni, Chiara, Jeffrey S. Berger, Tracy Y. Wang, Funda Gunes, Amanda Stebbins,
Karen S. Pieper, Rowena J. Dolor, Pamela S. Douglas, Daniel B. Mark & L.
Kristin Newby. (2010). "Prevention Representation of Women in Randomized
Clinical Trials of Cardiovascular Disease." Circ Cardiovasc Qual Outcomes 3:
Paynter, Nina P., Daniel I. Chasman, Guillaume Pare, Julie E. Buring, Nancy R. Cook,
Joseph P. Miletich, & Paul M. Ridker (2010). "Association between a Literature-
Based Genetic Risk Score and Cardiovascular Events in 19,313 Women." in
JAMA 303(7): 631 -- 637.
Pyrgakis, Vlassis N. (2010). "Women and Cardiovascular Disease." Hellenic J. Cardiol
Ridker, Paul M., Nancy R. Cook, I-Min Lee, David Gordon, J. Michael Gaziano, JoAnn
E. Manson, Charles H. Hennekens & Julie E. Buring (2005). "A Randomized
Trial of Low-Dose Aspirin in the Primary Prevention of Cardiovascular Disease
in Women." In the New England Journal of Medicine 352: 1293-1304.
Roncalli, Jerome, Meyer Elbaza, Nicolas Dumonteila, Nicolas Boudoua, Olivier Laireza,
Thibault Lhermusiera, Talia Chilona, Cecile Baixasa, Michel Galinier, Jacques
Puela, Jean-Marie Fauvela, Didier Carrie & Jean-Bernard Ruidavetsc (2010).
"Gender disparity in 48-hour mortality is limited to emergency percutaneous coronary intervention for ST-elevation myocardial infarction." In Archives of Cardiovascular Disease 103: 293-301.
Shirato, Susan & Beth Ann Swan (2010). "Women and Cardiovascular Disease: An
Evidentiary Review." In Medsurg Nursing 19: 282-306.
Silva, Gisele, Fabricio O. Lima Erica C.S. Camargo…
Most of the studies stressed the need for additional research in their given area of investigation, and gender differences it would seem remain better described than understood. Conclusion The research showed that there were some documented biological differences in the incidence of heart disease among American men and women, and these differences were further accentuated by a number of gender-related behaviors that may account for some of the disparity between the
Probable causes accounting for this are a holdup in the identification of cardiovascular ailment in women might not be enough to reveal medical implication. Variation in the accepted chronology of coronary arterial ailments is found in the genders, especially connected with the effect of menopause. Age of appearance, appearing of signs, influence of different causes of danger, and results of treatment vary between the sexes. (Tecce; Dasgupta; Doherty, 22) In
AGING It is a generally known fact that some weaknesses in the body start developing that directly or indirectly affect one's mental health. Since physical health is related to its impact on the mental health visible in later stages of life, older people must take extra care of their mental health. This paper aims at first, graphically representing mental health conditions in older people in the form of Microsoft Word Excel
During the study a number of factors were considered for the evaluation of the fact that females unlike males in Saudi Arabia constitute a larger proportion. Themes Lifestyle and dietary Adolescent boys and girls were studied for at least two weeks on their feeding habits, for this period, females were observed to consume more snacks than male in that males could only consume snacks once a fortnight unlike their female counterparts who
knowledge statements on Cardiovasular Diseases among Minority Women in U.S. Globally, cardiovascular diseases (CVD) accounts for the single largest cause of death among women, causing 8.6 million deaths annually (Keyhani et al., 2008). In the U.S., it is estimated that about 38.2 million women currently live with CVD and more women than men die each year from CVD (Mosca et al., 2007). Cardiovascular disease varies substantially not only across gender
Women and Health Agenda Over the Last 20 Years This review is about women's health demands and their contribution in creating a healthy society. For many decades, World Health Organization (WHO) has had tremendous measures that concern women's health. Women's health remains a crucial priority by various healthcare agencies. This review explains why various healthcare institutions take a great initiative in ensuring that women's health remains an urgent priority in the