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Heart disease affects women differently than men

Kathleen Blanchard's picture
Women's heart disease manifests differently than men

Women with heart disease are found to have different manifestations compared to men. Researchers say the difference in the way heart disease manifests in women is why women are often misdiagnosed.

Women more likely to have small vessel heart disease

For women, heart disease symptoms may be subtle – but when a heart attack strikes, women are more likely to die than men. Women are also at twice the risk of death following open heart surgery, compared to men.

Researchers say when men have heart disease it affects the larger blood vessels, but in women, the small blood vessels become diseased.

Appropriate treatments needed to manage women’s heart disease

According to C. Noel Bairey Merz, MD, Director of the Women’s Heart Center at Cedars-Sinai Heart Institute in Los Angeles, “Physicians have been looking for male pattern disease, when we need to start looking at female patterns.” Likewise, more research is needed to develop appropriate treatments and reduce risk in women.”

One of the differences between women who have heart disease, compared to men, is how blockages in the coronary arteries affect the heart muscle says Bairey.

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Heart damage is more likely to occur in women when the small blood vessels become obstructed from plaque.

Women are also more likely to maintain heart function after a heart attack, unlike men whose heart muscle becomes weaker; 38 percent of women die from heart attack, making heart attack more lethal for women than men.

Women are also more likely to have a second heart attack within six years of their first one, unlike men.

Bairey says women are also less likely than men to have obstructive coronary artery disease.

Bairey presented her findings to clinicians at the Physiology of Cardiovascular Disease: Gender Disparities conference, October 14, at the University of Mississippi in Jackson.

She says the good news is there are ways to measure damage to the small blood vessels objectively. The gold standard is reactivity testing, angiograms, and other physiologic measures, rather than anatomic study.”

Compared to men, women are more likely to die from heart attack. A woman’s heart is also more resilient after damage occurs from heart attack.

Men tend to have macrovascular (large blood vessel) disease compared to women who suffer heart damage from microvascular (small vessel) heart disease. The finding from the researchers advances understanding of how to manage women’s heart disease that manifests differently than men.

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