Rationale: Women with cardiovascular disease are treated less aggressively than men. The reasons for this disparity are unclear. Pharmaceutical advertisements may influence physician practices and patient care. Aims and objective: To determine if female and male patients are equally likely to be featured in cardiovascular advertisements. Methods: We examined all cardiovascular advertisements from US editions of general medical and cardiovascular journals published between 1 January 1996 and 30 June
1998. For each unique advertisement, we recorded the total number of journal
appearances and the number of appearances in journals' premium positions. We noted the gender, age, race and role of both the primary figure and the majority of people featured in the advertisement. Results: Nine hundred and nineteen unique cardiovascular advertisements were identified of which 254 depicted a patient as the primary figure. A total of 20% [95%
confidence interval (CI) 15.3-25.5%] of these advertisements portrayed a
female patient, while 80% (95% CI 74.5-84.7%) depicted a male patient,
P < 0.0001. Female patient advertisements appeared 249 times (13.3%; 95%
CI 8.6-18.9%) while male patient advertisements appeared 1618 times
(86.7%; 95% CI 81.1-91.4%), P < 0.0001. Female patient advertisements
also had significantly fewer mean appearances than male patient advertisements
in journals' premium positions (0.82 vs. 1.99, P=0.02). Similar results
were seen when the advertisements were analysed according to predominant
gender. Conclusions: Despite increasing emphasis on cardiovascular disease in women, significant under-representation of female patients exists in cardiovascular advertisements. Physicians should be cognizant of this
gender bias.Ontario Ministry of Health Services Research
Career Scientist AwardOntario Ministry of Health Services Research
Career Scientist Awar