Cardiovascular Disease in Women: Exploring Clinical Signs and Risks Factors

Dr. Bernadine Healy, first female director of the National Institutes of Health (NIH), recognized that most of the research centered on the diagnosis and treatment of coronary artery disease in men, not women, thereby making men the normative standard.  Because of this, women’s symptoms became underappreciated or atypical, with fatigue being the most common complaint especially in older adult women with acute myocardial infarction. Women often present with nausea, jaw tightness, shortness of breath, muscle pain, dizziness, and chest pressure, although their symptoms are often milder than those of their male counterparts. Up to 30% of women may have no chest pain at all. This is important because heart disease is the leading cause of death for women in the United States, accounting for over 398,000 deaths per year (American Heart Association). This figure is greater than the next two leading causes of death in women, cancer and accidents, combined (American Heart Association). While it has been shown that men have myocardial infarctions at earlier ages than women, myocardial infarctions result in greater mortality in women than in men.

 

The pathophysiology and risk factors are also different in women. Women often exhibit coronary microvascular dysfunction, which is marked by smaller vessels and increased vascular stiffness with diabetes and hypertension being the most common risk factors in women. Many women with hypertension are undiagnosed or, if diagnosed, poorly controlled. Smoking increases heart disease risk significantly in women, raising it to the same level as in men. Interestingly, in women, the cardiovascular risk varies relative to menopause. Prior to menopause, protective high density lipoprotein levels, are elevated. After menopause, they decrease and women lose the protective advantage. Early induction of menopause has also been associated with increased cardiovascular risks.


Maureen Farrel   DUCOM 2021

 

https://www.goredforwomen.org/fight-heart-disease-women-go-red-women-official-site/share-your-story/