Women are less likely than men to receive treatment for a form of heart valve disease, a new study supported by the British Heart Foundation reveals.
The research showed that after a diagnosis of aortic stenosis, women are 11% less likely to be referred on to secondary care and 39% less likely to have a procedure to replace their aortic valve, when compared to men with the same diagnosis.
People from ethnic minority backgrounds and those living in the most deprived areas are also less likely to receive treatment after diagnosis than other patients.
Related Article: Increased risk of heart disease with adult-onset type 1 diabetes
Researchers from the University of Leicester presented the findings at the 2025 British Cardiovascular Society Conference, highlighting the inequalities in diagnosis, referral, and treatment for AS across the UK.
Aortic stenosis is the most common type of heart valve disease in the UK, occurring when the aortic valve tissue thickens and narrows the valve. Treatment involves replacing the damaged valve through either open-heart surgery or a minimally invasive keyhole procedure.
Using anonymised GP records from NHS practices in England, the researchers identified nearly 155,000 people diagnosed with aortic stenosis between 2000 and 2022. They analysed rates of referral to secondary care and aortic valve interventions alongside data relating to sex, ethnicity and socioeconomic status.
Of the 154,223 patients newly diagnosed with aortic stenosis, half of the patients were women, who were typically diagnosed at an older age than men. The majority of patients were White British (93%), with the remainder identifying as South Asian (3%), Black (1%), or of mixed or other ethnicities. Patients from ethnic minority groups and those living in the most deprived areas were generally diagnosed at a younger age compared to other groups.
Primary care clinicians made approximately 80% of the diagnoses, and referred 28% of these cases to secondary care. Women and people living in the most deprived areas experienced the lowest rates of referral. In terms of treatment, women were significantly less likely to receive valve replacement procedures than men.
Related Article: Multiple chronic illnesses could double risk of depression
Dr Anvesha Singh, associate Professor at the University of Leicester, who was involved in the research, said: ‘Previous studies have shown lower rates of valve replacement in women, and clinicians had assumed that women were less likely to be diagnosed with aortic stenosis. Our study highlights potential inequities in management and care of this common and serious condition.’
In addition, people from South Asian and Black backgrounds were less likely to receive treatment for aortic stenosis compared to White patients (27% and 48%, respectively) but they were more likely to be referred than White patients. Researchers say that this could reflect referrals for other heart issues not related to aortic stenosis.
In addition, the analysis shows that the patients living in the most deprived areas were 7% less likely to be referred for secondary care after their diagnosis than patients in the least deprived areas, and 4% cent less likely to undergo a procedure to replace their aortic valve.
Related Article: Mothers with anaemia more likely to have a baby with congenital heart disease
Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, said: ‘This study has unveiled disparities in access to aortic valve treatment for women, South Asian and Black people, and people living in more deprived communities.’
She added: ‘These findings are concerning, and we need more research to understand what is driving the differences. This will be crucial to enable action to address any underlying causes that are stopping some people from having access to the heart valve treatment and care they need when they need it.’
