13 Feb Feminine Gender Characteristics Linked To Worse Cardiac Outcomes
MedicalResearch.com Interview with:
Dr. Roxanne Pelletier
Roxanne Pelletier, PhD
Divisions of General Internal Medicine and of Clinical Epidemiology
Department of Medicine
The Research Institute of the McGill University Health Centre
Montreal, Quebec, Canada
Medical Research: What is the background for this study?
Dr. Pelletier: The increased risk of mortality in young females compared with males after acute coronary syndrome (ACS) remain difficult to understand. As gender-related characteristics has evolved considerably in the last decades (e.g. hours of paid work have increased significantly among women), we hypothesized that these sex differences in adverse outcomes following acute coronary syndrome are partly explained by gender, rather than by biological sex itself.
As explained in our paper, “Gender reflects social norms and expectations ascribed to women and men, in contrast to biological characteristics that are captured by sex. Gender can be referred to as the nonbiological aspects of being male or female (e.g., social roles, personality traits).Our team had previously shown that sex differences in access to care for ACS were partly explained by these gender-related characteristics, such that both men and women presenting with acute coronary syndrome and with personality traits and social roles traditionally ascribed to women (e.g. sensitive to the needs of others, shy, household responsibility, child care) were waiting longer before diagnostic tests and were less likely to receive invasive treatment procedures such as percutaneous coronary intervention, when compared to men and women with masculine gender-related characteristics. We then aimed to assess whether gender was also playing a role in sex differences in adverse outcomes following acute coronary syndrome.
Medical Research: What are the main findings?
Dr. Pelletier: We observed that in our cohort of young patients with acute coronary syndrome, gender-related characteristics traditionally ascribed to women are associated with adverse cardiovascular outcomes. Specifically, 12 months after the index ACS, the rates of recurrent acute coronary syndrome and of major adverse cardiovascular outcomes in general (i.e. ACS, revascularization procedure, cardiac mortality) were higher in patients with personality traits and roles traditionally ascribed to women compared with patients with personality traits and roles traditionally ascribed to men. With regards to recurrent ACS specifically, we further observed that the relationship with gender is independent from patients’ biological sex, age, ethnicity, previous cardiovascular events, ACS severity, and burden of traditional cardiovascular risk factors. Moreover, our data suggest that an increased level of anxiety may be one mechanism through which feminine gender-related characteristics increase the risk of recurrent acute coronary syndrome. In contrast, event rates did not differ between sexes.
Medical Research: What should clinicians and patients take away from your report?
Dr. Pelletier: Clinicians may want to keep in mind that gender-related characteristics such as personality traits and social roles (the psychosocial sex) may be as important as biological sex in predicting adverse cardiovascular outcomes in patients with premature acute coronary syndrome. They may therefore want to consider gender-related characteristics when planning secondary prevention strategies.
On their side, both women and men patients with premature acute coronary syndrome and feminine gender-related characteristics should be made aware of the risk of recurrent adverse events associated with child care and housework burden, as well as with marital strain and specific personality traits such as being too sensitive to the needs of others. These patients should also be advised to consult a mental health specialist, if they feel they need some help to understand how they can modulate the adverse effects related to their specific type of gender.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Pelletier: Future research could help to better understand the mechanisms underlying the association between feminine genders and adverse cardiovascular outcomes by including a patient-oriented qualitative design.
Citation:
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Roxanne Pelletier, PhD (2016). Feminine Gender Characteristics Linked To Worse Cardiac Outcomes
Last Updated on February 13, 2016 by Marie Benz MD FAAD