Gender differences in the presentation, treatment, and short-term mortality of acute chest pain

Clin Invest Med. 1994 Dec;17(6):551-62.


The Halifax County MONICA database was used to estimate the gender bias in presentation, prehospital and in-hospital treatment, and 28-d mortality of patients suffering an episode of acute chest pain. The study population consisted of all county residents aged 25-74, admitted between 1984 and 1990 to a CCU, or suffering a myocardial infarction anywhere in a hospital. The mean age for men was 58.5 (n = 6561), for women 61.5 (n = 3176). Women of all age groups were more likely to have a history of diabetes or hypertension, and below age 55 had a higher prevalence of peripheral vascular disease. Typical symptoms for infarction were present in 30.8% of women and 38.1% of men (p < 0.0001). More women were taking beta-blockers, Ca-antagonists, digitalis, diuretics, and nitrates (p < 0.001), and more men were on antiarrhythmics. A gender difference was observed for coronary arteriography (24% in men, 18% in women) and for the exercise stress test (23% in men, 18% in women). In hospital, men had more episodes of severe arrhythmias (OR = 1.52). Except for aspirin and antiarrhythmics, the difference in hospital medication and 28-d mortality (9.6% in women vs. 7.8% in men) could be explained by the existing clinical conditions.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Arrhythmia Agents / therapeutic use
  • Arrhythmias, Cardiac / complications
  • Aspirin / therapeutic use
  • Chest Pain* / mortality
  • Chest Pain* / therapy
  • Coronary Angiography
  • Exercise Test
  • Female
  • Humans
  • Hypertension / complications
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy
  • Risk Factors
  • Sex Factors


  • Anti-Arrhythmia Agents
  • Aspirin