Gender bias in the diagnosis and treatment of coronary artery disease.

Women are at high risk for cardiovascular disorders, but referrals for both diagnostic and therapeutic procedures seem to reflect a gender bias. Procedures and therapies currently used have been developed predominantly or exclusively for men. Medical history demonstrates a disregard of women's health problems that still may be operative today. Women are older and sicker when they have angioplasty or bypass grafting, and they receive far fewer implantable cardioverter defibrillators and heart transplantations. They have more hypertension, diabetes, longer stays in intensive care units, and poorer outcomes. This may be the result of a problem with referral or a difference in the way women experience cardiac symptoms. It may also be related to the way women perceive themselves and their illness. Efforts are being made to provide equitable and relevant health care for women and to conduct research that will describe women's cardiac symptoms and their responses to cardiovascular technology.