'Age discrimination' in heart care

Men get the best treatment after heart attack

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.

Ongoing medication

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.

Whether ageism is implicit or explicit within the health service, it cannot be allowed to continue any longer.

Age Concern

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.