Sex/gender bias in the management of chest pain in ambulatory care.

TitreSex/gender bias in the management of chest pain in ambulatory care.
Publication TypeJournal Article
Year of Publication2018
AuthorsLiaudat, CClerc, Vaucher, P, De Francesco, T, Jaunin-Stalder, N, Herzig, L, Verdon, F, Favrat, B, Locatelli, I, Clair, C
JournalWomens Health (Lond)
Date Published2018 Jan-Dec
Mots-clésAdult, Aged, Ambulatory Care, Attitude to Health, Chest Pain, Chest Pain/diagnosis, Chest Pain/epidemiology, Cohort Studies, Coronary Disease/diagnosis, Coronary Disease/epidemiology, Female, Humans, Inpatients/statistics & numerical data, Male, Medical History Taking/statistics & numerical data, Middle Aged, Primary Health Care/statistics & numerical data, Prospective Studies, Referral and Consultation/statistics & numerical data, sex differences, Sex Factors, sex/gender bias, Women's Health/statistics & numerical data, Young Adult

OBJECTIVE: Cardiovascular diseases (CVD) are the main cause of death worldwide and despite a higher prevalence in men, mortality from CVD is higher among women. Few studies have assessed sex differences in chest pain management in ambulatory care. The objective of this post hoc analysis of data from a prospective cohort study was to assess sex differences in the management of chest pain in ambulatory care.

SETTING: We used data from the Thoracic Pain in Community cohort study that was realized in 58 primary care practices and one university ambulatory clinic in Switzerland.

PARTICIPANTS: In total, 672 consecutive patients aged over 16 years attending a primary care practice or ambulatory care clinic with a complaint of chest pain were included between February and June 2001. Their mean age was 55.2 years and 52.5% were women.

MAIN OUTCOME MEASURES: The main outcome was the proportion of patients referred to a cardiologist at 12 months follow-up. A panel of primary care physicians assessed the final diagnosis retained for chest pain at 12 months.

RESULTS: The prevalence of chest pain of cardiovascular origin (n = 108, 16.1%) was similar for men and women (17.5% vs 14.8%, respectively, p = 0.4). Men with chest pain were 2.5 times more likely to be referred to a cardiologist than women (16.6% vs 7.4%, odds ratio: 2.49, 95% confidence interval: 1.52-4.09). After adjustment for the patients' age and cardiovascular disease risk factors, the estimates did not significantly change (odds ratio: 2.30, 95% confidence interval: 1.30-3.78).

CONCLUSION: Although the same proportion of women and men present with a chest pain of cardiovascular origin in ambulatory care, there is a strong sex bias in their management. These data suggest that effort must be made to assure equity between men and women in medical care.

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Alternate JournalWomens Health (Lond)
Citation Key / SERVAL ID9216
PubMed ID30370833


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