During the first 60 days after heart attacks, women receive fewer aggressive treatments than men even though a higher percentage of women die or become disabled following heart attacks, according to a report from the Blue Cross Blue Shield Association and Blue Health Intelligence.

The researchers found that women were 27 percent less likely than men to receive angioplasties, 38 percent less likely to undergo CABG and nearly five percent less likely to receive coronary angiography.

“As healthcare moves towards the era of personalized or precision medicine, the differences between women and men may play an increasing role in diagnosis and treatment,” Trent Haywood, MD, JD, chief medical officer for the Blue Cross Blue Shield Association, said in a news release. “The findings from this report highlight the need for additional examination of treatment patterns and social determinants of heart health at the local and national level.”

The results, which were released on Sept. 29, were based on claims data from more than 43 million Blue Cross Blue Shield commercially insured members between 18 and 64 years old. The researchers excluded Medicare and Medicaid beneficiaries.

Among Blue Cross Blue Shield members in 2014, 0.73 of every 1,000 women and 1.95 of every 1,000 men had a heart attack. For women and men, heart attack rates were higher in the East, Midwest and Southeast and were lower in the West and Northwest.

States with the highest heart attack rates tended to exceed the national average for at least two of the following three risk factors: physical inactivity, obesity and smoking.

In the U.S., 30.1 percent of people are physically inactive, 29.1 percent are obese and 19.2 percent smoke, according to 2013 data from the government’s Behavioral Risk Factor Surveillance System.

The researchers cited an American Heart Association report that found women are more likely than men to die within a year of a heart attack, have another heart attack within six years and become disabled because of heart failure within six years.

“Women’s hearts are under-researched, under-treated and get misdiagnosed far more often than our male counterparts – facts further underscored by The Health of America Report,” Paula Johnson, MD, professor of medicine at Harvard Medical School and executive director of the Connors Center for women’s health at Brigham and Women’s hospital in Boston, said in a news release. “With heart disease as the leading cause of death among women in the U.S., more research to understand the sex differences in heart disease in order to diagnose and treat women’s unique hearts should be a national priority.”