Professor André Ng
President, British Cardiovascular Society
Women and minorities often receive suboptimal cardiology care, facing delays and reduced access to life-saving procedures. Addressing these disparities through prevention, education and policy is crucial.
Cardiology combines fast-moving technology, successful medical procedures and innovative drug and device treatments — all of which we offer to patients to improve their quality of life and avoid early and unexpected death. However, not all of these treatments are offered equally to all patients.
Women badly served in cardiology
For example, women having a heart attack are up to 50% more likely than men to receive the wrong initial diagnosis and are more likely to have palpitation symptoms of heart rhythm disturbance passed on as panic attacks leading to delay in treatment.
There are also significant differences in access to heart valve replacement surgery, without which people are at risk of uncontrolled symptoms and worsening outcomes. Recent UK research has shown that women, ethnic minority populations and those living in deprived areas are much less likely to receive life-saving surgery to replace a failing heart valve (women 30% less, Black people 26% less, people of South Asian descent 22% less and people from deprived areas 24% less likely).
Women having a heart attack are up
to 50% more likely than men to
receive the wrong initial diagnosis.
Inequity among ethnic minorities and deprived populations
It is the people most in need of diagnosis and treatment who are missing out; people from ethnic minorities and deprived populations are already more likely to have major risk factors for heart disease such as hypertension, diabetes and obesity. This has been seen as a wider public health issue, with cardiologists becoming involved once the person has been identified as a patient, but it is clear going forward that primary prevention is key.
Timely, effective management of risk factors would reduce the incidence of heart disease, addressing all aspects of inequality. It will be difficult; cardiology has huge waiting lists and major workforce shortages — but having determined the extent of the problem, we owe it to our patients to address it urgently on all fronts.
Prioritising equal heart care
As doctors, we have the responsibility to do our best for the patients under our care. However, we also need wider societal measures — public education to encourage healthy lifestyles, legislation to ban advertising of unhealthy foods and, most importantly, a cross-government strategy to tackle all the factors that make people ill in the first place. As the newly elected BCS president, I will be making equality in access to heart treatment a priority.
