After a first severe heart attack, women face a 20% increased risk of developing heart failure or dying within five years when compared with men, according to new findings. A fresh look at patient care may be warranted, investigators say.

Researchers analyzed about six years’ worth of health data from more than 45,000 patients (31% women) who were hospitalized for a first heart attack between 2002 and 2016 in Canada. They focused on severe, life-threatening heart attacks called ST-segment elevation myocardial infarction (STEMI), and the less severe and more common Non-STEMI attacks. 

While women experienced fewer heart attacks than the men, they developed heart failure more often for both types of heart attack — either in the hospital or after discharge. They also had a higher adjusted rate of death in the hospital than men in the STEMI group, though not in the Non-STEMI group.

Female participants were on average 10 years older, with more health complications than the men, putting them at a greater risk for heart failure, noted lead author Justin Ezekowitz, M.B.B.Ch., MSc, a cardiologist with the University of Alberta, in Edmonton. But women were seen less frequently in the hospital by a cardiovascular specialist, and were less likely to be prescribed medications such as beta blockers or cholesterol-lowering drugs. They also had slightly lower rates of procedures to restore blood flow, such as surgical angioplasty.

The results suggest that providers should ask whether all patients — particularly women — are receiving the best care, said co-author Padma Kaul, Ph.D., of the Canadian VIGOUR Centre, a research institution.

“Identifying when and how women may be at higher risk for heart failure after a heart attack can help providers develop more effective approaches for prevention,” Ezekowitz added. He recommends promoting better adherence to cholesterol reduction, high blood pressure control and other standard heart health measures such as getting more exercise, stopping smoking and eating a healthy diet. 

These measures, “combined with recognition of these problems earlier in life would save thousands of lives of women — and men,” he concluded.

The study was published Monday in the journal Circulation.