Men more likely to get life-saving device: study

CHICAGO (Reuters) - Men are two to three times more likely than women to get a life-saving heart device known as an implantable defibrillator, a study of U.S. Medicare patients showed on Tuesday.

Implantable defibrillators are pacemaker-like devices that can detect lethal heart rhythms and shock the heart back into proper rhythm, saving patients from sudden death.

"This is definitely bad news for women. There is no getting around that," said Lesley Curtis of Duke University School of Medicine in Durham, North Carolina, whose study appears in the Journal of the American Medical Association.

The large study of elderly patients is in line with prior research that suggests women do not get the same standard of care as men.

The researchers said more study was needed to reveal the reasons behind these disparities.

"We have a lot more work to do in this area," Curtis said. "I really hope when we do this work we find it is not overt sexism."

Curtis and colleagues analyzed data from the U.S. Centers for Medicare and Medicaid Services from 1991 through 2005 on more than 136,000 patients 65 or older who were at high risk for sudden cardiac death.

She found men were 3.2 times more likely than women to receive an implantable defibrillator.

To account for the fact that women live longer than men, which could skew results by comparing older women with younger men, she narrowed her analysis to men and women under age 75.

The results were similar, with men 2.4 times more likely to get an implantable defibrillator.

"It's very, very consistent," Curtis said in a telephone interview.

"We're not talking about a small difference. The magnitude is striking. These devices have been shown to save lives. We can't sugar coat that," she said.

A second study in the same issue of the journal by Dr. Adrian Hernandez, also of Duke, looked at 13,000 patients admitted to hospitals with heart failure who were at risk of sudden cardiac death.

He found women and blacks were significantly less likely than white men to receive an implantable defibrillator.

Compared with white men, the odds of receiving an implantable defibrillator were 27 percent lower for black men, 38 percent lower for white women and 44 percent lower for black women.

Sudden cardiac death arises when electrical problems keep the heart from pumping properly. It is responsible for half of all heart disease-related deaths.

Common risk factors include blocked heart arteries, a prior heart attack and a low ejection fraction, a measure of the heart's ability to pump blood.