Physicians' attitudes toward preventive therapy for coronary artery disease: is there a gender bias?
BACKGROUND
While much of the gender difference in the treatment of coronary artery disease (CAD) results from the fact that the women being treated are older and have more comorbidities, it remains to be established whether a true gender bias exists. We compared physicians' attitudes and practice toward preventive therapy in men and women with CAD.


OBJECTIVE
Physicians perceive the prevention of CAD in men as more important than in women.


METHODS
In the "attitude study," we obtained data on the attitudes of 172 physicians toward treatment, using hypothetical case histories of 58-year-old male and postmenopausal female patients with identical clinical and laboratory data and mild coronary atherosclerosis on angiography. In the "actual practice study," we evaluated the lipoprotein levels and prescription of lipid-lowering medications from medical records of 344 male and female patients with angiographic evidence of CAD.


RESULTS
In the hypothetical case histories, physicians in general considered the male patient to be at higher risk and prescribed aspirin (91 vs. 77%, p < 0.01) and lipid-lowering medications (67 vs. 54%, p < 0.07) more often for the male patient. Evaluation of medical charts of patients with CAD revealed that in patients with baseline low-density lipoprotein cholesterol > 110 mg/dl, 77% of the males received a lipid-lowering medication, compared with only 47% of the female patients (p < 0.001).


CONCLUSIONS
We found evidence for a gender bias in the attitude as well as in actual practice of secondary prevention toward patients with CAD. While the proportion of male patients receiving lipid-lowering medications appears appropriate, the proportion of women receiving such treatment remains undesirable.
Abuful
Akranm
A
Cardiology Department, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Gidron
Yori
Y
Henkin
Yaakov
Y
D000328:Adult; D001241:Aspirin / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003327:Coronary Disease / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011287:Prejudice; D018570:Risk Assessment
D005343:Fibrinolytic Agents; D000960:Hypolipidemic Agents; D001241:Aspirin