Coronary heart disease (CHD) symptoms are attributed to stress more frequently in women than men, according to a new study. Life stressors hit women harder.
Presented at the 20th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, the study can help understand why there is often a delay in the assessment of women with heart disease.
The researchers were of the opinion that the presence of life stressors or anxiety would shift the interpretation of women`s CHD symptoms, but not men`s, and thus they would be perceived to have a psychogenic etiology.
For their study, the researchers read a vignette of a 47-year-old male or a 56-year-old female (by age at equal risk for CHD) presenting a multitude of CHD symptoms and risk factors. Half the vignettes included sentences indicating the patient had recently experienced a life stressor, and that they appeared anxious.
Each physician read one version of the vignette and then specified a diagnosis, made treatment recommendations, and indicated the etiology of symptoms. The researchers observed tha the presence of stress shifted the interpretation of women`s chest pain, shortness of breath and irregular heart rate so that these were thought to have a psychogenic origin. By contrast, men`s symptoms were perceived as organic whether or not stressors were present.
The researcher warned: "Given the overlap of CHD and anxiety symptoms (e.g., chest tightness common in both) and given the higher prevalence of anxiety symptoms or disorders in women, physicians need to be aware of gender differences in symptom presentation and they need to be especially careful to rule out CHD before considering an anxiety diagnosis. In the case of women, anxiety appears to have a pervasive influence on medical judgments regardless of the gender of the health care provider making the evaluations."
Prior to conducting this research, the researchers had tested their hypothesis with 99 first year medical students, 82 third and fourth year medical students, and 122 physician assistant students.
They were surprised to find nearly identical results whether the participants surveyed were first year medical students or experienced practicing family physicians and internists.
Bureau Report
