The Yentl syndrome is alive and well

Extract

This editorial refers to ‘Are we using cardiovascular medications and coronary angiography appropriately in men and women with chest pain?’^†, by N. Johnston et al., on page 1331and‘Factors influencing underutilization of evidence-based therapies in women’^‡, by R. Bugiardini et al., on page 1337

More women than men die annually from ischaemic heart disease (IHD) in the developed world. This represents a reversal of fortune from previous decades and places women firmly as the new majority now impacted.¹ Notably, the adverse IHD gender gap is the widest in relatively young women, where myocardial infarction (MI) mortality is 2-fold higher in women under 50 years compared with age-matched men.² While it is now clear that there are many gender differences in IHD outcomes, including more frequent angina diagnosis, more office visits, more avoidable hospitalizations, higher MI mortality, and higher rates of heart failure in women compared with men,¹ the aetiologies contributing to these differences are less clear.