Al Hamid Abdullah, Beckett Rachel, Wilson Megan, Jalal Zahra, Cheema Ejaz, Al-Jumeily Obe Dhiya, Coombs Thomas, Ralebitso-Senior Komang, Assi Sulaf
Pharmacy Practice, King Faisal University, Al Ahsa, SAU.
Forensic Science, Liverpool John Moores University, Liverpool, GBR.
Cureus. 2024 Feb 15;16(2):e54264. doi: 10.7759/cureus.54264. eCollection 2024 Feb.
Cardiovascular disease (CVDs) has been perceived as a 'man's disease', and this impacted women's referral to CVD diagnosis and treatment. This study systematically reviewed the evidence regarding gender bias in the diagnosis, prevention, and treatment of CVDs. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. We searched CINAHL, PubMed, Medline, Web of Science, British Nursing Index, Scopus, and Google Scholar. The included studies were assessed for quality using risk bias tools. Data extracted from the included studies were exported into Statistical Product and Service Solutions (SPSS, v26; IBM SPSS Statistics for Windows, Armonk, NY), where descriptive statistics were applied. A total of 19 studies were analysed. CVDs were less reported among women who either showed milder symptoms than men or had their symptoms misdiagnosed as gastrointestinal or anxiety-related symptoms. Hence, women had their risk factors under-considered by physicians (especially by male physicians). Subsequently, women were offered fewer diagnostic tests, such as coronary angiography, ergometry, electrocardiogram (ECG), and cardiac enzymes, and were referred to less to cardiologists and/or hospitalisation. Furthermore, if hospitalised, women were less likely to receive a coronary intervention. Similarly, women were prescribed cardiovascular medicines than men, with the exception of antihypertensive and anti-anginal medicines. When it comes to the perception of CVD, women considered themselves at lower risk of CVDs than men. This systematic review showed that women were offered fewer diagnostic tests for CVDs and medicines than men and that in turn influenced their disease outcomes. This could be attributed to the inadequate knowledge regarding the differences in manifestations among both genders.
心血管疾病(CVDs)一直被视为“男性疾病”,这影响了女性接受心血管疾病的诊断和治疗。本研究系统回顾了有关心血管疾病诊断、预防和治疗中性别偏见的证据。遵循系统评价和Meta分析的首选报告项目(PRISMA)指南。我们检索了护理学与健康领域数据库(CINAHL)、医学期刊数据库(PubMed)、医学文献数据库(Medline)、科学引文索引数据库(Web of Science)、英国护理索引数据库、Scopus数据库和谷歌学术。使用风险偏倚工具评估纳入研究的质量。从纳入研究中提取的数据被导出到统计产品与服务解决方案(SPSS,v26;IBM SPSS Statistics for Windows,纽约州阿蒙克市),并应用描述性统计。共分析了19项研究。在症状比男性轻或症状被误诊为胃肠道或焦虑相关症状的女性中,心血管疾病的报告较少。因此,医生(尤其是男性医生)对女性的风险因素考虑不足。随后,女性接受的诊断测试较少,如冠状动脉造影、运动试验、心电图(ECG)和心肌酶检测,被转诊至心脏病专家处和/或住院的次数也较少。此外,如果住院,女性接受冠状动脉介入治疗的可能性较小。同样,除抗高血压和抗心绞痛药物外,女性服用心血管药物的情况比男性少。在对心血管疾病的认知方面,女性认为自己患心血管疾病的风险低于男性。这项系统评价表明,女性接受的心血管疾病诊断测试和药物比男性少,这反过来又影响了她们的疾病结局。这可能归因于对两性表现差异的认识不足。