Research in SCMH has helped shape the Scottish Governments 'Women's Health Plan'

Research into heart disease in women involved a collaboration with Prof Colin Berry, Drs Rachel Jackson and Pardeep Jhund, colleagues in the Robertson Centre for Biostatistics, NHS Golden Jubilee and C. They found predictable and unexpected differences in the clinical care and outcomes of women who experienced a heart attack in Glasgow and the West of Scotland.

Their results raised particular concerns in relation to younger women, who should naturally be protected from having a heart attack. They highlighted their results to the Scottish Government and as a direct consequence, heart disease was included in the Women’s Health Plan.

Professor Berry says:

"It has been my privilege to contribute to the Women’s Health Group’s work, including to propose Champions for Women’s Health in Health Boards. The aim is to reduce disparities in healthcare and improve clinical outcomes for women presenting with heart disease at different stages of life.

The Women’s Health Plan underpins actions to improve women’s health inequalities by raising awareness around women’s health, improving access to health care and reducing inequalities in health outcomes for girls and women, both for sex-specific conditions and in women’s general health.

Publication: Women's Health Plan

BBC News: Scotland bids to be 'world leader' in women's health

RESEARCH

Healthcare disparities for women hospitalized with myocardial infarction and angina

Alice M Jackson, Ruiqi Zhang, Iain Findlay, Keith Robertson, Mitchell Lindsay, Tamsin Morris, Brian Forbes, Richard Papworth, Alex McConnachie, Kenneth Mangion, Pardeep S Jhund, Colin McCowan, Colin Berry

Link to Paper: academic.oup.com

Aims

Ischaemic heart disease persists as the leading cause of death in both men and women in most countries and sex disparities, defined as differences in health outcomes and their determinants, may be relevant. We examined sex disparities in presenting characteristics, treatment and all-cause mortality in patients hospitalized with myocardial infarction (MI) or angina.

Methods and results

We conducted a cohort study of all patients admitted with MI or angina (01 October 2013 to 30 June 2016) from a secondary care acute coronary syndrome e-Registry in NHS Scotland linked with national registers of community drug dispensation and mortality data. A total of 7878 patients hospitalized for MI or angina were prospectively included; 3161 (40%) were women. Women were older, more deprived, had a greater burden of comorbidity, were more often treated with guideline-recommended therapy preadmission and less frequently received immediate invasive management. Men were more likely to receive coronary angiography [adjusted odds ratio (OR) 1.52, confidence interval (CI) 1.37–1.68] and percutaneous coronary intervention (adjusted OR 1.68, CI 1.52–1.86). Women were less comprehensively treated with evidence-based therapies post-MI. Women had worse crude survival, primarily those with ST-elevation myocardial infarction (14.3% vs. 8.0% at 1 year, P < 0.001), but this finding was explained by differences in baseline factors. Men with non-ST-elevation myocardial infarction had a higher risk of all-cause death at 30 days [adjusted hazard ratio (HR) 1.72, CI 1.16–2.56] and 1 year (adjusted HR 1.38, CI 1.12–1.69).

Conclusion

After taking account of baseline risk factors, sex differences in treatment pathway, use of invasive management, and secondary prevention therapies indicate disparities in guideline-directed management of women hospitalized with MI or angina.

First published: 23 August 2021

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