Abstract
Society has come a long way over the past several decades from the old fashion belief that cardiovascular disease (CVD) is a man’s disease. Throughout the years, gender-based studies have provided compelling evidence to uncover several unique features in disease presentation, pathology and primary prevention in women. Studies reviewing differences among men and women have placed specific emphasis on cardiovascular risk factors, symptoms and vascular pathology as potential etiologies for the higher cardiovascular mortality and disability among women. In addition, although weight loss and exercise have been shown to promote cardiovascular health in men, more recently findings have presented data to support the importance of these interventions among women. Although tremendous strides have been made throughout the years in the gender-based cardiovascular research, more questions than answers remain and additional research efforts are still needed to better understand the disease process in women. The objectives of this review are two-fold: First, to present a comparative analysis focusing on evidence-based similarities and differences among males and females in cardiovascular disease presentation, detection and clinical pathology; Second, to offer insights highlighting recent findings regarding primary prevention and treatment protocols in women. Based on our current knowledge, continued efforts geared toward optimal diagnostic testing and screening protocols for primary disease detection and risk factor modification programs are recommended. This would include further investigations of the potential role that genetics and/or environment play/plays in the natural progression of the disease process. Additionally, comprehensive lifestyle interventions aimed at reducing cardiovascular disability and mortality in women is also recommended.
Highlights
Society has come a long way over the past several decades from the old fashion belief that cardiovascular disease (CVD) is a man’s disease, this owing to an overwhelming number of gender-based research findings focusing on disease prevention, pathogenesis and progression in women
Scientific research is only beginning to uncover the unique features associated with CVD among women and female minorities by examining differences in the biological, pathophysiological and therapeutic areas
We have managed to identify the following unique characteristics among women: - An increased awareness of the crucial role that diabetes mellitus plays in the disease process and the higher cardiovascular mortality and morbidity in women with diabetes
Summary
Society has come a long way over the past several decades from the old fashion belief that cardiovascular disease (CVD) is a man’s disease, this owing to an overwhelming number of gender-based research findings focusing on disease prevention, pathogenesis and progression in women. Findings have provided alarming evidence to support an increase in the cardiovascular death rate in young women between the ages of 35 - 44 years (1.3% annually since 1997) [5], and an astounding 69% percent higher mortality rate among black women compared with white women [2] [6] This progressively earlier disease onset may be related to changes in modern lifestyle and the fact that younger women appear to focus less on healthy cardiovascular lifestyles compared with their male counterparts. Women tend to develop myocardial infarction and heart failure at a later age compared with men, [9] and female patients who suffer from heart failure with preserved ejection fraction may have a survival advantage over the male counterparts in the long term [10] [11] This suggests a gender difference in disease risk, development and progression. The purpose of this review is to highlight gender-based similarities and differences in CVD presentation and pathology that have been obtained through the years and to provide insights into primary prevention of CVD in women
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