Sex differences in the pathophysiology, treatment, and outcomes in IHD.

Monika Sanghavi,Martha Gulati

doi:10.1007/s11883-015-0511-z

Abstract

Heart disease is the number one killer of women. Although there are many similarities between men and women, the evolving understanding of ischemic heart disease in women allow us to emphasize the important differences that need to be recognized. These differences, including symptoms at presentation, importance of particular risk factors, pathophysiology of disease, and treatments/outcomes, will be discussed in this review.

Highlights

Women in the USA are more likely to die of cardiovascular disease (CVD) than any other cause [1]
The overall incidence of coronary heart disease (CHD) is lower in women; across all age strata, a myocardial infarction (MI) is more likely to be fatal in women, in younger women [1]
ischemic heart disease (IHD) is a broader term that encompasses any disorder or disease that results in myocardial ischemia; this includes Cardiac Syndrome X, a term used to describe patients with symptoms and evidence of ischemia but no obstructive coronary artery

Summary

Introduction

Women in the USA are more likely to die of cardiovascular disease (CVD) than any other cause [1]. Coronary heart disease (CHD) makes up the majority of events for both men and women below 75 years of age [1]. The incidence of CHD in women lags behind men by 10 years, suggesting a protective effect in women that is lost with advanced age, after the onset of menopause. The overall trends suggest a decrease in incident CHD events and CHD-related deaths over the past 20– 25 years in both men and women, the only exception is younger women (35–44 years of age) for whom the mortality has increased [3]. We know that certain risk factors are stronger predictors of heart disease in women, there are sex differences in symptoms, and there are differences in the underlying pathophysiology. IHD is a broader term that encompasses any disorder or disease that results in myocardial ischemia; this includes Cardiac Syndrome X, a term used to describe patients with symptoms and evidence of ischemia but no obstructive coronary artery

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Findings

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