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'Age discrimination' in heart care

Wednesday, 15 November, 2000, 00:11 GMT - Women in the UK are less likely
to receive specialist treatment and life-saving drugs after a heart attack
than men.

But researchers believe that ageism rather than sexism may account for the
difference, because women are generally older when they suffer heart problems.

A study of 2,196 patients admitted to Yorkshire hospitals after a heart
attack found 61% of women were admitted to a coronary care unit compared
with 74% of men.

And women were less likely to be given clot-busting drugs or to be given
investigations such as angiography or exercise-testing or to be offered
surgery on damaged arteries.

But the study found that, when age was taken into account, the differences
between the sexes were no longer significant.

Writing in the Journal of Epidemiology and Community Health, the research
team said: "On the basis of ethics and clinical knowledge, age should not
be used as a determining factor in treatment decisions, yet this continues
to be the case."

Death rates after a heart attack in hospital were 30% compared with 19% for
men.

Yet those women who survived and were discharged were much less likely to
be prescribed ongoing medication including aspirin and beta blockers -
treatments the researchers say "have a significant impact on survival".

The research team found the death rate for women two years after a heart
attack was higher than that for men, though this was mainly attributed to
age, previous risk factors and the treatment received at the time.

But they concluded: "Women have a worse prognosis after AMI (heart attack)
and under-treatment of older people with aspirin and thrombolysis may be
contributing to this."

This ageism in terms of access to NHS treatment has been highlighted by Age
Concern over the past year.

The charity said it was aware that 40 per cent of coronary care units
attach age restrictions to the use of clot-busting drug therapy.

An Age Concern survey of GPs in April showed the existence of upper age
limits in NHS treatment and surgery, particularly in respect to heart
transplants and heart bypass operations, as well as admission to intensive
therapy units.

"Whether ageism is implicit or explicit within the health service, it
cannot be allowed to continue any longer. The government needs to reassure
older people that ageism will be tackled at every level where it is in
existence," a spokeswoman said.

In a bid to eliminate age discrimination, Health Secretary Alan Milburn has
recently appointed Professor Ian Philp as the NHS' anti-ageism tsar.

He will chair an older people's taskforce to contribute to the NHS
modernisation programme.

Related to this story:
Women fare worse in heart care (04 Jun 99 | Health)
NHS appoints anti-ageism czar (03 Nov 00 | Health)
Aspirin use 'harms some patients' (30 Jun 00 | Health)
'Vigorous exercise' fights heart disease (30 Aug 00 | Health)
Doctors told to use 'super aspirin' (29 Sep 00 | Health)

Internet links:
British Medical Association
Age Concern
British Heart Foundation

BBC News Online: Health
http://news.bbc.co.uk/low/english/health/newsid_1023000/1023237.stm

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