Gender Bias in Stroke Care

I can't think of any adequate excuse for womenthat a stroke had occurred--but found that these
to receive medical care that is less good than thatcould not account for the differences, either.
which is received by men. However, evidence forIn truth, the extent of testing in even the men
this continues to surface. The latest study tofell below standards of care--and probably does
demonstrate this unsettling fact was published inso in other communities as well--but for the
the September 27, 2005, issue of Neurology, thecurrent discussion, the emphasis is on the
official journal of the American Academy ofdifferences in care provided to the two genders.
Neurology. Melinda Smith and co-investigatorsSo, if these results can be generalized to practices
looked at stroke care between 2000 and 2002 inelsewhere, the sad truth is that if you are a
the seven acute-care hospitals of Corpus Christi,woman with a stroke, your care will not be as
Texas, which includes all of the hospitals ofgood as if you are a man. And, unfortunately, the
Nueces County.gender bias in stroke care demonstrated by
Patients hospitalized for stroke, a condition inthese researchers was not an isolated example.
which interrupted circulation causes damage to theThe authors reviewed the results of other studies
brain, should receive a core battery of testing.that showed:
Every stroke patient should receive an- Sixty-two percent of stroke deaths in the
echocardiogram, a soundwave-based test thatUnited States occur in women.
shows images of the heart and its various- Women have a lower incidence of stroke but
components in motion. This is useful in showing ifworse outcomes than men.
the heart might have generated the stroke by- One hospital's study showed that in their
sending clots or other material into the circulationemergency department women with strokes
feeding the brain, and also to identifywere evaluated less quickly than men with
complications affecting the heart itself. Moreover,strokes were.
patients believed to have a stroke to the front- A multinational, hospital-based study showed
part of the brain (which applies to most cases)fewer brain-imaging, heart-imaging and
should receive testing for narrowing or blockageblood-vessel-imaging studies in women than in
of the carotid arteries. The carotids are the twomen.
pulsating blood-vessels in the front of the neck- Women with strokes were less likely to receive
which convey blood to the front of the brain.blood-thinners than men were.
The researchers found that while 57% of the- And, women were less likely to receive surgery
men with strokes received an echocardiogram,to the carotid arteries than men were.
this test was given to just 48% of the womenWhat is more, gender differences in medical
with strokes. And while 71% of the men receivedtreatment of coronary artery disease have also
carotid imaging, this test was provided to justbeen demonstrated in Corpus Christi and
62% of the women. Statistics showed that theseelsewhere. So, as indicated by the authors, gender
differences were too large to account for bydifferences in medical care probably extend
chance alone. Moreover, the researchers diligentlybeyond the evaluation and treatment of strokes.
searched for legitimate medical reasons toOne conclusion is unavoidable: The medical
account for the unequal testing--like differences incommunity still has a long way to go in providing
stroke risk-factors or differences in recognitionequal care to all the patients entrusted to its care.