Women and Heart Disease: Understanding Your Risks

Women at risk

Breast cancer is far more publicized as a killer of women than heart disease. It’s the disease women are most aware of and fear the most. Breast cancer affects women of all ages and levels of physical fitness, while heart disease is generally an older woman’s health issue.
Even so, 500,000 women will lose their lives to heart disease this year compared to approximately 45,000 who will succumb to breast cancer.
Still, almost all public campaigns aimed at awareness for cardiovascular disease have been aimed at men, and, more important, most of the research to date has focused on male subjects.
As a direct result, the incidence of death from coronary artery disease (CAD) has decreased for men but has remained at the same level for women. Fortunately, this gender imbalance is now being addressed. Many researchers and physicians have spearheaded efforts to understand the gender issues related to CAD and to push for research aimed at women.

For more information regarding determining a woman’s risk for heart disease click here

The heart of a woman

When it comes to heart disease, there is a distinct gender gap—but it is one that is quickly closing thanks to on-going research efforts and extensive public education. While no one would be surprised to learn that heart disease is the leading cause of death for men in the world, it might come as a surprise to many that this also holds true for women.

According to the American Heart Association:

  • More than one million Americans die from the complications of coronary heart disease (CAD) annually. This is more than die of the next seven most common causes of death combined, including all forms of cancer.
  • The average middle-aged woman is unaware of these facts, and, therefore, generally not well informed about how to reduce her risk for developing CAD.
  • The average middle-aged woman is unaware of these facts, and, therefore, generally not well informed about how to reduce her risk for developing CAD.
  • More than half of the people who die from CAD are women
  • More than 500,000 American women lose their lives to heart disease (1 in 4 women) compared to 45,000 women who die from breast cancer (1 in 30 women).
  • Cardiovascular disease kills about one woman every minute in the United States.
  • Women are much more likely than men to die within a year of their first heart attack.
  • Two-thirds of women who have a heart attack fail to make a full recovery.
  • Within six years of having a heart attack, about 46% of women become disabled with heart failure.
  • One in eight women between the ages of 45 and 64 has some form of heart disease, and this increases to one in four women over age 65.

Women and Endothelial Dysfunction

Women and Endothelial Dysfunction

Although ischemic heart disease (IHD) is often considered a “man’s disease,” it takes the lives of more women than men each year. In fact, it’s estimated that about 60,000 more women than men die from cardiovascular disease annually in the United States.
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. Further, 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.
A new study may change this by offering greater insight into the causes behind chest pain in women and how it manifests differently in women than it does in men.
The study, published in the Archives of Internal Medicine in 2009 reports that women with chest pain but without coronary artery disease are at an elevated risk for cardiovascular events such as heart attack or stroke.
“These results combined with prior work suggest that women are not just smaller versions of men when it comes to heart disease,” said C. Noel Bairey Merz, M.D., director of the Women’s Heart Center at the Cedars-Sinai Heart Institute and the chair of the Women’s Ischemia Syndrome Evaluation (WISE) study. Sponsored by the National Heart Lung and Blood Institute, the WISE studies began in 1997 and have since pointed out how differently men and women experience symptoms of coronary heart disease.
Dr. Bairey Merz is using the EndoPAT device and has been advising Itamar over the years on heart-related medical issues.

Every woman who is 45 years of age and older should ask their doctor for the EndoPAT test.

Gender-related differences can be reflected in endothelial function

Heart disease is not gender neutral, according to the landmark WISE findings. Women and men experience heart disease differently and require different treatments. “Our findings challenge the accepted belief in the medical community that these patients should be considered low-risk, and points towards the need for a different treatment regimen for these patients moving forward,” said Martha Gulati, M.D., first author of the study, cardiologist, and associate director of the Center for Women’s Cardiovascular Health at Northwestern Memorial’s Bluhm Cardiovascular Institute.

For additional information regarding why heart disease is different for women click here

Check for Endothelial Dysfunction

The physicians hypothesize that this difficult-to-diagnose chest pain could be caused by microvascular angina and endothelial dysfunction, affecting blood vessels in which the layers of the cells are not functioning properly and may be undetectable by standard testing.
Researchers believe endothelial dysfunction to be the earliest stage of coronary artery disease—the risk of the risk factors.
The study authors recommend:

  • Women with chest pain symptoms should undergo initial testing for coronary artery disease.
  • If there is no evidence of coronary artery disease, patients should undergo further assessment for endothelial dysfunction.
  • If detected, patients should then undergo treatment to improve the dysfunction. The EndoPAT is the only FDA-approved device for this 15-minute in-office procedure.
  • Women with symptoms, but no presence of endothelial dysfunction, should work with physicians to aggressively modify certain risk factors for heart disease, such as smoking, weight control, and cholesterol.

Groundbreaking study: digital assessment of Endothelial Function and Ischemic Heart Disease in women

Ischemic heart disease is the medical term for coronary artery disease (CAD). 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, which is abnormal electrical activity in the heart.
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 heart disease in 140 women.
In a study published in the Journal of the American College of Cardiology in 2010, Dr. Matsuzawa reported that when they tested 140 stable women with EndoPAT who had reported minor chest pain but no other symptoms, EndoScores were significantly impaired in those women who were later diagnosed with non-obstructive coronary artery disease and obstructive coronary artery disease.
That means women without significant chest pain who have coronary heart disease can now be identified, because the non-invasive EndoPAT test can reliably predict the presence of ischemic heart disease in these 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 the EndoPAT test.