How Heart Disease Differs for Women and Men

The treatment of heart diseases mostly focuses on rectifying the obstructive coronary arteries problems of heart patients. But unlike men, many of the women with heart ailments may not have this problem. Hence, their problem may be graver compared to men.

C. Noel Bairey Merz, MD, director of the Women’s Heart Center at the Heart Institute at Cedars-Sinai Medical Center in Los Angeles, who is also the lead author of a review published in the Journal of the American College of Cardiology says that in the case of women, it is not the smooth passage of blood in the prime blood vessels of the heart rather than the decrease in the blood flow, known as ischemia in the small arteries of the heart is of concern. She and her research associates have come up with this conclusion after studying many researches correlating the occurrence of heart diseases and the gender difference.

Elaborating further, Bairey Merz explains, “Women in the age group of 45 to 64 are particularly susceptible to develop functional irregularities in the small arteries. Unfortunately, such vessels are not detected through the traditional angiograms and hence, it may create a false sense of reassurance.”

She and her group of researchers also suggest that, while the blocking of blood flow in the main coronary vessels is termed as coronary heart disease (CHD) and the term ischemic heart disease (IHD) should be used for the reduction in the blood flow in the small arteries.

Bair further reveals that around 20 years ago medical experts began to think that cardiac problems of women are not similar to that of the men. In fact, about 25 to 50 percent of women with cardiac ailment suffer from ischemic heart disease and not the CHD, a typical case of men.

This has been enumerated in their study of National Institutes of Health Women’s Ischemia Syndrome Evaluation (WISE) started in 1996 under the chairmanship of Bairey Merz.

The cardiac ailments of Men vs. Women

The nature and symptoms of heart problems in case of men and women are different. In case of men, the symptoms like unbearable pain and pressure in the chest that one come across the Hollywood movies are manifested. The women generally do not show these exertion symptoms but complain of pressure in the chest. Other symptoms of cardiac ailments in women include indigestion and gasping.

Bairey Merz also says that women are also more likely to develop functional irregularities in the small arteries. While there is fatty buildup in the large arteries and hence obstruction in the coronary arteries of men, the arteries of women are more open. Due to this, often their treatment is not fully optimized, as it does not fall in the pattern.

Bairey Merz says in this regard, “Instead of focusing on the obstructions in the main heart vessels, in case of women, care should be taken to look into the possibility of ischemia or ischemic cardiac problems.”

The other salient features of the study are as follows –

The rate of hospitalization of women due to cardiac problem is more than that of men. Also, they are at a higher risk of death due to it than men.
The number of women, who succumb to cardiac diseases, is more then that of the men in the United States annually – 455,000 women as against 410,000 men.
The level of C-reactive protein, an index of inflammation and a pointer of cardiac ailment, is more in women than men.
The Framingham Risk Score used traditionally to classify the risks of heart disease, puts more than 90 percent of women in the low risk category. But the newer method, the Reynolds Risk Score, may show a more appropriate measure for women.
Re-evaluating the medical findings

Giving credence to the study, Nieca Goldberg, MD a cardiologist and spokeswoman for the American Heart Association and the director of the New York University Langone Medical Center Women’s Heart Center and clinical associate professor of medicine at NYU, says,” The study has taken into account the smaller studies and have made an assessment of them for the doctors.”

Bairey Merz advises women, who think they have a cardiac disease, “Don’t be complacent about the fact that the angiogram report is okay. You might be having the syndrome of ischemia. So, if you suspect of any wrong diagnosis, always seek a re-evaluation or second opinion.”

She also assures that a number of hospitals have heart programs, exclusively meant for women.

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