Women hospitalized with heart attacks still don't get the treatment they need and are more likely to die than men if they suffer a massive heart attack, a new study of U.S. hospitals shows.

Overall, women survive heart attacks about as well as men when they are under a hospital's care. But the study found that a gender gap remains when women have the most serious type of heart attack. Women also get less of the recommended medicines and procedures than men, or it takes longer to get them.

"We're doing better but not good enough for women," said Dr. Hani Jneid, lead author of the study from Baylor College of Medicine in Houston.

The data came from 420 hospitals enrolled in an American Heart Association program to get doctors to follow guidelines for treating heart attack patients. Previous research has suggested that women's heart attacks were treated less aggressively.
The research was funded by the heart association and the findings were reported Monday in the group's medical journal, Circulation.

Dr. Nieca Goldberg, a cardiologist who specializes in women's care, said the study suggests that women's heart attack symptoms still are not being taken seriously. Some women don't have typical symptoms like chest pains, she said, but may have pain lower in their bodies or severe shortness of breath.

"This really continues to be very disappointing," said Goldberg, who is director of the Women's Heart Center at NYU Langone Medical Center in New York. "I think my colleagues need to get on the stick."

The study examined the hospital treatment for 78,254 heart attack victims to see if guidelines were followed and how many died. Hospitals in the heart association's "Get with the Guidelines" program are required to put that information in a registry.

When they looked at heart attacks overall, about the same number of men and women died in the hospital. But when they looked at the most serious kind of heart attack, there was a difference.

These heart attacks are caused by a total blockage of an artery, which deprives the heart muscle of oxygen and blood and causes part of it to die. Diagnosis is done with an electrocardiogram, which spots distinctive changes. Quick action is needed to open up the artery to restore blood flow, either with a clot-dissolving drug or an angioplasty.

About a third of the heart attacks in the study were major ones. The raw numbers showed 10 percent of the women with massive heart attacks died in the hospital, compared to about 6 percent of the men. After taking into account the women's older age and other differences, the researchers said the women in the study were 12 percent more likely to die of a major heart attack in the hospital than men.

The researchers said women were also less likely to get recommended medicines, like an aspirin within 24 hours. And they were less likely to get treatment to restore blood flow, or it wasn't given quickly enough.

Jneid said there may have been good reasons behind some of the differences; the researchers didn't know whether the treatment decisions were appropriate or not for specific patients.

But "there's no reason to see a disparity in something as simple as an aspirin," said Jneid.

Another of the researchers, Dr. Laura Wexler of the University of Cincinnati College of Medicine, noted that heart disease is usually thought of as a man's disease, but it is the leading cause of death among women.

"It's very important for the public — women and the people who love them — to get over the idea that it's not a disease of women," she said.