Why Heart Disease Is Different For Women
Family risk factors affect both men and women. However, when it comes to heart disease, women are different from men and often react differently to their disease and therapy. Let’s review some of these major differences.
Heart attack symptoms are different.Men and women often present differently when experiencing a heart attack. Men generally suffer from localized pain on the left side of the body (chest and/or arm), and they often describe this as a crushing, even debilitating pain. Women are more likely to experience exhaustion, dizziness, shortness of breath, or nausea. If they do have localized pain, it may be in the neck or jaw and in either or both arms. They will often describe flu-like and/or non-specific woes, and therefore, are easily misdiagnosed. Women are generally in their 70s when they suffer their first heart attacks, which far too often end up being fatal. That’s because so many of the early warning signs have been misunderstood or ignored. Women are also much more likely than men to die within a year of their first heart attack.
Diagnostic heart results are not the same for women.Another reason for the gender discrepancy in proper diagnosis of CAD is that women have more “false-positive” results from stress tests (recordings of the heart’s electrical activity while the patient uses a treadmill or stationary bicycle). Although the test is a helpful diagnostic tool, the rates of false-positive findings are higher in premenopausal women.In other words, the test is likely to suggest coronary artery disease in a woman who does not have the condition.
schemic heart disease is different for women, too.schemic heart disease is the medical term for coronary artery disease. While certainly treatable, ischemic heart disease is often “silent” and causes no noticeable symptoms in many people who have it—especially women. Even with available treatment, “silent” cases often go unnoticed in women and can result in sudden death due to a heart attack or an arrhythmia (abnormal electrical activity in the heart). Landmark research now reports that women’s disease is actually very different from that typically found in men, with a variety of complex underlying factors. And because women’s ischemic disease often evades detection through traditional diagnostic techniques that are based on men’s disease, it may continue to cause symptoms but remain undiagnosed until progressing to a critical stage. Understanding that older women were at particular risk for ischemic heart disease, Japanese researcher, Dr. Yasushi Matsuzawa, and his colleagues wanted to see if EndoPAT testing could predict the presence of ischemic disease in 140 women.
In a study published in the Journal of the American College of Cardiology in 2010, Dr. Matsuzawa reported that when 140 stable women who reported minor chest pain but no other symptoms were tested with EndoPAT, EndoScores were significantly impaired in those women who were later diagnosed with non-obstructive coronary artery disease and obstructive coronary artery disease. What this means is that women with coronary artery disease but without significant chest pain can now be identified using the non-invasive EndoPAT test. EndoPAT can reliably predict the presence of ischemic heart disease in women. With coronary artery disease the #1 cause of death in women, this important study makes clear that every woman who is 45 years of age and older should ask their doctor for an EndoPAT test.
Lower hormone levels during menopause raise women’s’ risk for heart attack.When it comes to heart disease, the hormone estrogen offers cardiac protection for women. With the loss of estrogen in menopause, however, low-density lipoprotein cholesterol (LDL, the “bad” cholesterol) levels begin to climb and high-density lipoprotein cholesterol (HDL, the “good” cholesterol) levels begin to drop. In fact, postmenopausal women have greater levels of total cholesterol than do men of the same age. Combine this with an unhealthy elevation of triglycerides, and postmenopausal women over the age of 65 are left at a higher than expected risk of death from heart disease. Hormone replacement therapy (HRT) is a controversial issue. At one time HRT—which was taken primarily to relieve menopausal symptoms, or as a second-line drug to help prevent the debilitating bone thinning of osteoporosis—was thought to guard women against heart disease. It’s now believed that HRT is linked to a small increase in heart attack and stroke in a small segment of susceptible women. The American Heart Association has stopped recommending HRT for postmenopausal women interested in lowering their risk of heart disease. And with postmenopausal women with lower levels of the protective hormone estrogen now vulnerable to the problems of heart disease and osteoporosis (the unnatural thinning of their bones), this medical dilemma still has no solutions in the foreseeable future. What to do? Early intervention with a comprehensive cardiovascular risk-reduction plan that includes EndoPAT testing offers women the best chance to prevent and halt the progress cardiovascular disease.