Related Experiment Video
Updated: Aug 16, 2026
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Physicians' attitudes toward preventive therapy for coronary artery disease: is there a gender bias?
Akranm Abuful1, Yori Gidron, Yaakov Henkin
1Cardiology Department, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Physicians show gender bias in treating coronary artery disease (CAD). Men with CAD received more preventive therapies, including aspirin and lipid-lowering medications, than women in both hypothetical and real-world scenarios.
Area of Science:
- Cardiology
- Medical Ethics
- Health Disparities
Background:
- Existing research suggests gender differences in coronary artery disease (CAD) treatment may stem from older age and comorbidities in women.
- However, the presence of a true gender bias in CAD management remains to be definitively established.
- This study directly compares physician attitudes and actual practice regarding preventive therapy for male and female CAD patients.
Purpose of the Study:
- To investigate potential gender bias in physician perceptions and treatment decisions for coronary artery disease (CAD).
- To assess whether physicians prioritize CAD prevention in men over women.
- To compare the prescription rates of preventive therapies between male and female CAD patients.
Main Methods:
- A hypothetical case study involved 172 physicians evaluating identical clinical data for male and female patients with mild coronary atherosclerosis.
- An actual practice study analyzed medical records of 344 male and female patients with angiographically confirmed CAD.
- Lipoprotein levels and lipid-lowering medication prescriptions were key metrics evaluated in both study arms.
Main Results:
- Physicians perceived male patients as higher risk and were more likely to prescribe aspirin and lipid-lowering medications in hypothetical scenarios.
- In actual practice, 77% of male CAD patients with elevated LDL cholesterol (>110 mg/dl) received lipid-lowering medication, versus only 47% of female patients.
- A statistically significant gender disparity (p < 0.001) was observed in the prescription of lipid-lowering medications.
Conclusions:
- Evidence of gender bias was found in both physician attitudes and the actual practice of secondary prevention for coronary artery disease (CAD).
- While male CAD patients received appropriate lipid-lowering treatment, the rate for female patients was found to be undesirably low.
- These findings highlight a critical need to address gender disparities in cardiovascular care to ensure equitable treatment for all patients.
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.
Hypothesis:
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.
Related Concept Videos
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease I: Introduction
01:27Coronary Artery Disease V: Interprofessional Care
01:26Atherosclerosis III: Management
01:27Panic Disorder
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...