A smaller body surface is thought to account for some of the difference in outcomes between men and women, probably because of smaller coronary vessels. Women are older than men, and are more likely to be hypertensive, diabetic, and obese when they present for surgery. Controlling for age explains a good part of the difference, as women on average are older, but a small difference remains that is not fully accounted for in current research. Men are more likely than women to develop coronary heart disease at a younger age, and approximately half of all coronary bypass surgeries are performed on people younger than 65 years of age. Women are less likely to be referred for surgery or angioplasty.
Explanations are numerous.
Differences in disease presentation and severity, age, and comorbidities all may account for disparity in treatment. Understanding and explaining gender differences in outcomes after angioplasty or coronary bypass surgery becomes increasingly important as the number of both men and women undergoing cardiac procedures increases. The complex interconnectedness between psychological, social, and biomedical variables should not be overlooked in the study of factors influencing recovery after a heart attack or a cardiac procedure. Women, partially because of their older age, are more likely to be unmarried and live alone, and tend to have less education than men. All of these are risk factors for negative outcomes.