Coronary Risk and Treatment: Differences Between Men and Women

Research is identifying sex differences in heart disease that may help fine-tune prevention, diagnosis, and treatment in women. Harvard Medical School offers the following examples:

1. Blood lipids.

After menopause, women have higher concentrations of total cholesterol than men do. And elevated triglycerides also contribute to cardiovascular risk in women. Low HDL and high triglycerides appear to be the only factors that increase the risk of death from heart disease in women over age 65.

2. Diabetes.

Women with diabetes often have added risk factors, such as obesity, hypertension, and high cholesterol, when compared to men with diabetes. In women who’ve already had a heart attack, diabetes doubles the risk for a second heart attack and increases the risk for heart failure.

3. Metabolic syndrome.

Metabolic syndrome is a clustering of at least three
of following medical conditions: abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein (HDL). This cluster increases chances of developing heart disease, stroke, and diabetes. Harvard Medical School research suggests that, for women, metabolic syndrome is the most important risk factor for having heart attacks at an unusually early age.

4. Smoking.

According to researchers from Johns Hopkins and the University of Minnesota, the risk for heart disease increased by 25 percent in women smokers compared to men. Additionally, women who smoke double their risk of coronary heart disease compared to non-smoking women.

5. Symptoms.

According to research from Harvard Medical School, women don’t always experience the same symptoms of a heart attack as men do. For example, rather than the crushing chest pain men often experience when having a heart attack, women may feel extreme fatigue and/or shortness of breath. During a heart attack, only about one in eight women reported chest pain; even then, they described it as pressure, aching, or tightness rather than pain. See Chart 1 on adjacent page for typical symptoms of heart attack in women.

6. Diagnosis and treatment.

Women are physiologically different than men in many ways (e.g., they have smaller coronary arteries and respond differently to standard exercise stress tests), and these differences can impact proper diagnosis and treatment of a heart attack and a woman’s ability to achieve optimum recovery. Women tend to have more complications following surgery, and are twice as likely to continue having symptoms several years after coronary angioplasty.

Source: Harvard Health Publications site. Harvard Medical School. Gender matters: heart disease risk in women. health/gender-matters-heart-disease-risk-in-women. Accessed 1 May 2017.

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