Monash University study finds women waiting longer for life-saving heart treatment

Cardiovascular disease is the biggest killer of Australian women — so why are they waiting longer than men for a procedure that could save their lives?

Researchers say unconscious gender bias may be playing a role in women waiting longer for a life-saving heart procedure.

Cardiovascular disease is the biggest killer of Australian women, yet a new study has found women are waiting longer than men for a common lifesaving heart valve treatment.

The relatively simple and effective procedure known as transcatheter aortic valve implantation (TAVI) helps to improve a damaged aortic valve, but because of Australia’s ageing population they are in high demand.

Researchers say unconscious gender bias may also be playing a role in women waiting longer.

The study team, led by cardiologist Dr Julia Stehli from Monash University’s School of Clinical Sciences and Monash Health, found waiting times for a lifesaving TAVI were significantly longer in women compared to men.

Dr Stehli says the team suspects some doctors perceive women to be at lower risk for worse outcomes compared to men. Another possibility, Dr Stehli says, is that women may take longer to accept a date for the procedure because of other responsibilities such as being the primary carer and prioritising the care of others over their own.

Dr Stehli said there were even greater wait times for women during Covid, but that this may have been because of limited childcare availability and because women traditionally put the care and needs of others ahead of their own.

“They may also have been more fearful of entering hospital during the pandemic,” she said.

The Monash University-led study warns waiting longer for a TAVI can lead to more deaths, hospitalisations and decreased mobility.

Researchers say unconscious gender bias may be playing a role in women waiting longer for a life-saving heart procedure.

“TAVI has revolutionised how we treat a common heart condition,” study co-author Associate Professor Tony Walton said.

The Head of the Structural Heart Program at The Alfred, he says the procedure replaces the need for more invasive open heart surgery.

Asked why women were waiting longer, he said it was likely a combination of unconscious gender bias but also women not recognising they may have a heart issue.

“Some women tend to think they don’t have anything wrong and they present later; we still don’t really understand why,” he says

According to the Australian Institute of Health and Welfare, about half a million women have cardiovascular disease and there are more than 100 acute coronary events in women reported every day.

Dr Stehli said when a patient presents with aortic stenosis they face a significantly reduced life expectancy, so procedures like TAVI need to be performed as soon as possible.

“However, with an ageing population the Australian health system is experiencing a backlog of patients, men and women, waiting for TAVI,” she said.

Associate Professor Walton said the condition, which is fixable, develops slowly over time.

“People think they are slowing down because of age, or they feel tired, but they should talk to their GP.

“It is also up to GPs to listen to a patient’s heart. Just put a stethoscope on a chest and hear a noise. GPs are busy and under a lot of pressure, but a blood pressure check and a stethoscope to listen to the heart can help identify issues earlier.”

The results of the study were published in December in the European Heart Journal and looked at 345 patients who underwent TAVI in an Australian metropolitan hospital between August 2018 and June 2021.