Gender and the Treatment of Heart Disease in Older Persons in the United States, France and England: A Comparative, Population-Based View of a Clinical Phenomenon

Background: Gender disparities in the treatment of coronary artery disease (CAD) have been extensively documented in studies from the United States. However, they have been less well studied in other countries and, to our knowledge, have not been investigated at the more disaggregated spatial level of cities.

Objective: This study tests the hypothesis that there is a common international pattern of gender disparity in the treatment of CAD in persons aged > 65 years by analyzing data from the United States, France, England and from their largest cities - New York City and its outer boroughs, Paris and its First Right, and Great London.

Conclusions: A consistent pattern of gender disparity in the interventional treatment of CAD was seen across 3 national health systems with known differences in patterns of medical practice. This finding is consistent with the results of clinical studies suggesting that gender disparities in the treatment of CAD are due at least in part to the underdiagnosis of CAD in women.