Coronary artery disease (CAD) kills more women than men each year, yet women are still not receiving as many preventive recommendations as men, according to a paper published in Global Heart.
Researchers from Ohio State University wanted to analyze the risk for CAD in women, as well as its impact and female-specific strategies for treatment.
They found that the disease should be managed differently for women, based on varying risk factors related to pregnancy and autoimmune diseases.
According to the authors, 8.6 million women die each year around the world from heart-related diseases, making up a third of all deaths in women. Additionally, cardiovascular diseases are the number one cause of death for both males and females worldwide.
Although the researchers note that awareness about the impact of CAD on women is slowly increasing, it still has a long way to go. In 2004, a survey revealed that only one in five doctors acknowledged that more women die each year from CAD. In addition, women are 55% less likely to participate in cardiac rehabilitation activities than men.
The authors say:
Deaths from CAD in the US fell by 30% between 1998 and 2008, but rates are going up in younger women under 55 years of age.
A number of risk factors differ between men and women, the authors note:
- Obesity raises risk of coronary artery disease by 64% in women, but by only 46% in men.
- Women who suffer a heart attack related to CAD at a younger age are twice as likely to die as their male counterparts.
- 42% of women are likely to die within a year of suffering a heart attack versus 24% of men.
- Women are 20% more likely to suffer angina than men.
The researchers say that women have narrower coronary arteries than men, and so are more likely to suffer CAD as a result of microvascular disease – disease of the heart affecting its small arteries.
The danger, the researchers say, is that while women may not appear to have major blockages of the coronary artery, they do suffer blockages of the smaller vessels. They add that over half of symptomatic women who do not have obstructive CAD still have signs and symptoms of ischemia.
“Women are affected by CAD in large numbers and to a large degree,” the researchers say. “CAD is the leading cause of mortality in women. The manifestation of CAD has unique characteristics in women. Increasing data demonstrate that some treatment strategies have sex-specific effectiveness.”
The researchers add:
“Further research regarding the pathophysiology of CAD in women, diagnosis and treatment strategies specific to women is required.
CAD is not a ‘man’s only’ disease, and we eagerly await future studies that examine its unique presence in women.”