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medpundit |
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Tuesday, January 21, 2003Researchers found that beta blockers, which slow the heart rate, were used by only a third of the women who should have been taking them. Only half the women who qualified for cholesterol-lowering drugs took them. Even aspirin was underused: Though all of the heart attack survivors in the study should have been taking it, only 80 percent did. The research highlights "a terrible discrepancy between what we know and how we treat our sisters and mothers," Drs. Andrew Miller and Suzanne Oparil of the University of Alabama at Birmingham said in an accompanying editorial. "This report confirms previous evidence that women with (heart disease) are being undertreated in the United States." Hard to say, truthfully, if women are being treated any differently than men. The study only looked at women, and women who were already known to have heart disease: The study, in Tuesday's Annals of Internal Medicine, involved 2,763 postmenopausal women with heart disease. All had suffered heart attacks or chest pain caused by blocked arteries, or had undergone bypass surgery or angioplasty. The study found that doctors often fail to prescribe aspirin, beta blockers and cholesterol-lowering drugs to these women, even though the medications have been shown to prevent further heart attacks or other heart trouble. I don’t have access to the full article, but the abstract notes this finding: At entry into HERS, 83% of participants were receiving aspirin or other antiplatelet agents, 33% were receiving -blockers, 18% were receiving angiotensin-converting enzyme inhibitors, and 53% were receiving lipid-lowering drugs. Women with more risk factors were less likely to be taking aspirin (P < 0.001) and lipid-lowering drugs (P = 0.006). The fact that women with more risk factors - diabetes, congestive heart failure, poorly functioning kidneys - received less aspirin and lipid-lowering drugs suggests to me that perhaps they didn’t receive them because of side effects or contraindications. That’s the problem with studies like this that just rely on data from other studies. They don’t take into account the individualilty of the research subjects and the nuances of appropriate patient care. If you put a woman with a bleeding ulcer or renal insufficiency on the drugs they mention, she might not die of a heart attack, but she will die of a GI bleed or acute renal failure or liver failure. Sometimes in our zeal for prevention, we forget that dictum of “do no harm.” posted by Sydney on 1/21/2003 08:10:00 AM 0 comments 0 Comments: |
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