News
Women face ‘striking inequalities’ in NHS heart care, study shows
Women are less likely to get the treatment recommended in clinical guidelines if they have a heart attack or are diagnosed with heart failure
Women face stark inequalities in diagnosis and treatment of four of the most common heart conditions in the UK, new research has shown.
The study, published in The Lancet Regional Health – Europe, found that women are less likely than men to undergo coronary angiograms, a crucial procedure to look inside their heart’s arteries, after a heart attack, and are less likely to be prescribed preventative treatments for heart attacks.
The findings, led by the University of Leeds and funded by the British Heart Foundation, highlighted an estimated 500 potentially avoidable deaths in the UK each year among patients waiting for treatment for aortic stenosis, a narrowing of the heart’s aortic valve which restricts blood flow around the body.
The British Heart Foundation said the research paints a “concerning picture of unequal care”, reinforcing the need for all political parties to prioritise efforts to tackle cardiovascular disease and health inequalities.
Professor Chris P Gale, professor of cardiovascular medicine at the University of Leeds and honorary consultant cardiologist at Leeds Teaching Hospitals NHS Trust who led the study, said: “We need urgent action to revive heart care.
“The NHS is full of fantastic people who make truly monumental efforts every day to do the very best for their patients. Despite this, the NHS is creaking at the seams and we see this played out in cardiovascular care and outcomes.
“Past efforts to transform heart care and drive down waiting lists were hugely successful and we must build on the lessons from these to move forward.”
He added: “It’s clear that we’re not making the most of NHS data and we’re missing vital opportunities for this to inform policy and help target investment.
“We need a systematic approach to collect data and report on all aspects of treatment, care and outcomes. Only then will we be able to improve patient’s experiences and outcomes across the board.”
Researchers brought together evidence from studies published over the last 20 years that explored how a person’s age, sex, ethnicity and postcode are linked to the heart care they receive and their outcomes.
The team focused on heart attacks, heart failure, atrial fibrillation and aortic stenosis as these conditions lead to significant pressure on the NHS.
Prompt treatment is crucial after a diagnosis of severe aortic stenosis, as around 50 per cent of patients will die within two years of symptoms beginning.
The review showed that older people and women are less likely to receive the treatment recommended in clinical guidelines if they have a heart attack or are diagnosed with heart failure.
While the evidence for age, sex and geography was clear, the researchers said it is harder to draw conclusions about the experiences of patients of different ethnicities due to a lack of evidence.
However, from the studies available they concluded that disparities do exist. For example, there was evidence that black patients with atrial fibrillation, a common type of abnormal heart rhythm, are less likely to receive blood thinning treatment to prevent stroke than white patients.
Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and consultant cardiologist, said: “These findings should sound the alarm bell for the state of heart care in the UK.
“This concerning review is further evidence that people’s experience of heart care was far from equal even before the pandemic began. The pandemic underlined and amplified existing health inequalities and we fear these are worse than ever now that we are firmly in the grip of a heart care crisis.”
She continued: “To stop this crisis in its tracks and address the unjust inequalities in heart care, we need bold action from the government. Protecting our hearts by tackling risk factors will help to prevent heart disease and strokes happening in the first place.
“Prioritising NHS heart care will allow people to get the help they need more quickly, preventing avoidable death and disability. And powering up research will unlock the treatments and cures of tomorrow to give more people hope for a bright and healthy future.”
Australia’s drug advisory committee has recommended wider funding of triptorelin for women with breast cancer or endometriosis.
The recommendation comes after AstraZeneca announced plans to remove Zoladex from the market, risking leaving more than 7,500 women with breast cancer without an alternative treatment.
Both medicines block the release of oestrogen and testosterone and can be used as part of treatment, or for fertility preservation, in some forms of cancer.
The Pharmaceutical Benefits Advisory Committee met urgently in July and recommended making triptorelin unrestricted under the Pharmaceutical Benefits Scheme (PBS), which would mean it was funded for all uses.
The drug has been listed on the PBS for prostate cancer since 2006.
Triptorelin and Zoladex can also be used to treat endometriosis and to block puberty for either precocious puberty or gender-affirming care.
Vicki Durston, director of policy and advocacy at Breast Cancer Network Australia, described the recommendation as “a significant step forward” and said access to the medicine could mean the difference between life and death for some patients.
She said some women had already chosen to have their ovaries removed because of uncertainty over Zoladex supplies.
Marilla Druitt, Victorian state chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said it remained unclear whether triptorelin would work exactly the same way as Zoladex, but the recommendation was likely to be positive for patients with endometriosis and pelvic pain.
She said: “I’m glad we’ve got an alternative.”
“That’s fantastic, and it remains to be seen whether or not it will be as good, but pain is so complex, pain is a really hard thing to study because it’s got so many contributors.”
Druitt said further research would be needed after the medicine was introduced.
If accepted by the federal government, the recommendation would also allow PBS funding of triptorelin for puberty suppression in precocious puberty and gender-affirming care.
This would make gender-affirming care federally funded through the PBS for the first time and would remove a financial barrier for transgender children in Queensland and the Northern Territory.
Stuart Aitken, medical director of Gender Health Australia, said the recommendation had sparked “absolute joy” among his patients.
He said: “It takes away a huge barrier to accessing evidence-based care.”
“It means that the ban has a very limited effect.”
By Women’s HealthX
As healthcare organisations navigate tightening compliance mandates, evolving reimbursement frameworks, and shifting health economics, the single most critical asset for leadership is operational visibility into what their industry counterparts are executing right now.
Ahead of the Women’s HealthX marketplace in Boston this December, a cross-functional steering committee of health plans, hospital networks, biopharma innovators, and enterprise employers has launched the definitive 2026 U.S. Health Infrastructure Survey.
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- Health Systems & Providers “What is the biggest women’s health priority for health systems over the next 24 months?”
- Pharma & Life Sciences “What is the biggest commercial hurdle facing women’s health innovation?”
- Employers & Benefits Leaders “Which women’s health challenge creates the greatest workforce impact?”
By contributing just 60 seconds of your operational insight to the index, you will ensure your specific sector’s parameters are accurately represented.
In return for your participation, you will secure a priority, pre-ordered copy of the completed 30-page intelligence report when the final data drops this September!
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Encore Boston Harbor | December 3-4 2026
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Sahar Abid is a Science Associate at Ema EQ, where she works on cultural sensitivity and bias in AI.
A woman asks an AI health assistant about postpartum depression.
She mentions that her in-laws are telling her to “push through” and skip medical help, even as her symptoms get harder to manage. She never says where she is from or names her background.
The assistant describes the condition and gives her a hotline number. It sounds correct, but it misses what she needs.
That gap is more common than the industry admits, and it points to a blind spot in how we test health AI for bias.
Most bias testing looks at what people explicitly say.
The typical way to check an AI for bias is to label a prompt with someone’s demographic details and see if the answer changes. That catches some problems but misses a bigger one.
Most people do not lead with their identity. They lead with their situation. The woman above told the assistant everything it needed to help her, just not in the form of a label.
Her real question was not only “what is postpartum depression?” It was “how do I get care when the people around me don’t want me to?
When family members hold sway over health decisions, and in many communities they do, advice that asks someone to overrule their family is not something they can act on.
The AI didn’t say anything factually wrong. It answered a different question than the one she was living.
We call this culturally implicit bias, meaning the AI misses the cultural context a situation implies rather than the context a person spells out.
When systems are trained to notice only the explicit cues, they fall back on a default answer built for the majority. For everyone else, the response can feel generic, off-target, or discouraging enough that they stop looking for help.
In health, that is not small. The people most likely to be missed are often the ones the system already underserves.
What we set out to test.
At Ema, we wanted to know how well AI picks up on cultural context that is implied but never stated. So we built our own way to test for it, across a range of communities and real situations like postpartum depression and fertility, using questions that carried cultural meaning without announcing it.
The patterns were consistent. Models often missed the meaning underneath the question. They dropped the specific details a person did share and smoothed them into something generic.
And even when they pointed toward real care, they tended to offer one option instead of choices that might actually fit a person’s life. Any one of those can be the difference between someone following the advice and walking away from care.
Why this matters for anyone building health AI.
Getting this right is the right thing to do, and it also works better.
When an answer reflects a person’s real context, people trust and act on the recommendations more, so they get the help and support they need.
Testing for it is harder than the shortcut most teams use. Swapping a name or a demographic label in and out is easy. Checking whether a model actually understands the human context around a question takes more care.
The shortcut teaches models to perform cultural competence instead of practicing it. No matter how much or how little someone chooses to share, they deserve an answer that is warm, complete, and usable.
A better question.
The bar for equitable health AI should be “does it serve someone who never told you who they are?” It is the harder test, but it determines whether real people get help.
The work of getting there is far from finished, and it is exactly what we are building toward at Ema.
Sources: Naidoo, V., & Chadha, K. K. (2025), Culturally responsive AI chatbots: from framework to field evidence, Computers in Human Behavior: Artificial Humans. Souligne, N., & Subbian, V. (2026), FairLogue: A toolkit for intersectional fairness analysis in clinical machine learning models.
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