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HowToPreventHeartDisease.com |
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Is Heart Disease In Women Different From Men? Among 8.6 million women died of heart disease and stroke annually, 5.6 million were caused by heart disease, according to the World Heart Federation. In the United States, heart disease is the No. 1 killer of women, and it causes 1 in 3 women’s deaths each year. Many women believe heart disease is for men, but such perception is obviously incorrect. A paper published in ‘Lancet’ in 2011 reported that women smokers had a 25 percent higher risk of coronary heart disease than male smokers in a large meta-analysis of more than 2 million men and women by Huxley. Intrinsic biological differences between women and men could be the cause for such disparity. In fact, the nature, symptoms and risks of heart disease in women are quite different from that in men. Heart attack usually occurs 10 years later in women compared to men, possibly due to female hormones. A large multinational study (Interheart study), however, showed that 90 percent of heart attacks were due to risk factors and the earlier start in men could be accounted for by the higher prevalence of risk factors like higher cholesterol and smoking. Higher risk of coronary artery disease was seen once the menopause in women starts. There was belief that women’s heart could be protected by the presence of the female hormones, and so hormone replacement therapy (HRT) was routinely given to post-menopausal women. But subsequent trials, the Estrogen/progestin Replacement Study (HERS) and the Women's Health Initiative (WHI), had shown that post-menopausal HRT did not prevent heart disease but instead raised the risk of stroke.
While coronary heart disease (CHD) remains the number killer of women, other kinds of heart disease like coronary microvascular disease (MVD) and broken heart syndrome, also pose a risk for women. These disorders, which mainly affect women, are not as well understood as CHD. Coronary MVD is heart disease that affects the heart's tiny arteries, and broken heart syndrome refers to severe heart muscle failure (often short-term) caused by extreme emotional stress. 64 percent of women who die suddenly of coronary heart disease had no previous symptoms. Chest pain on exertion or angina remains the main symptom for women with underlying coronary heart disease, but compared to men, women are more likely to show non-specific symptoms such as shortness of breath, nausea/vomiting and back or jaw pain. Other symptoms such as dizziness, lightheadedness or fainting, pain in the lower chest or upper abdomen and extreme fatigue can also be seen in women. Women respond differently to medications, too. Results of the Physician's Health Study in men showed that aspirin conferred a protective effect against heart attack but not stroke. But the Women's Health Study published in the ‘New England Journal of Medicine’ in 2005 showed that aspirin consumption would help against stroke but not for prevention of heart attack. Another bad news for women is that they have a poorer outcome when they get a heart attack. They are at an increased risk of dying during the hospital admission, developing recurrent heart attacks, going into heart failure and getting a stroke. Nevertheless, studies showed that doctors could potentially improve outcomes for women by providing an equally aggressive approach to deliver optimal medical therapy and offer options to open obstructed heart arteries for women. Though women can have normal heart pumping capacity, they develop heart failure. This is because women are more likely to develop stiff hearts where the heart chamber is unable to relax fully resulting in an increased resting pressure in the heart chamber. This may sometimes cause congestion of the lungs and shortness of breath. In severe cases, water enters the lung and sudden heart failure results. Fortunately, lowering fluid intake for the period, when there is shortness of breath, can easily prevent this. By understanding how women’s hearts respond and behave differently from men, doctors can recognize women’s heart disease symptoms and provide better treatment with improved outcomes.
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