20.06.2018 change 20.06.2018

Expert: Women are more likely to die from cardiovascular diseases

Photo: Fotolia Photo: Fotolia

Cardiovascular diseases appear later in women, than in men, and the symptoms may be completely different. But women more often die because of them, Dr. Małgorzata Peregud-Pogorzelska from the Pomeranian Medical University said during the conference "Quo vadis medicina?".

"Cardiovascular disease is more attributed to the male sex" - said Dr. Peregud-Pogorzelska. "But according to European research, women are more likely to die because of it: 55 percent women compared to 43 percent men" - she added.

Women themselves see it differently. According to German research, as many as 2/3 of the surveyed women consider breast cancer to be the greatest risk and the most common cause of anxiety. Only 25 percent indicate cardiovascular disease.

When William Heberden described angina pectoris in 1772, the cases he knew mainly concerned men. "If you find a man with cardiac discomfort, with pain in his arms, at the side of his heart, death is near". "I have seen nearly a hundred people under this disorder, of which number there have been three women, and one boy twelve years old. All the rest were men near, or past the fiftieth year of their age" - he wrote. But, as a study involving 5000 patients carried out in 2000 showed, while 19% of men have the unusual symptoms of angina, in women it is as much as 60%.

Heart attack in particular is perceived as a "male disease". While in men the symptom of a heart attack is usually typical retrosternal pain, women may have gastrointestinal complaints, nausea, shortness of breath, fatigue, decreased exercise tolerance or clogging.

In the case of a heart attack, statistical data confirm its more frequent occurrence in men - moreover, male heart attack sufferers are 10 years younger than women. This is largely due to the protective effects of estrogens that act directly on the cardiovascular system and modulate gene expression. While women before menopause are less at risk, afterwards they are more likely to have a heart attack and heart failure. Women survive the acute phase of myocardial infarction more often than men, but later they are more likely to die - especially in the first 30 days after the infarction, women`s mortality is 2-3 times higher.

Strokes are more common in women. Women account for as much as 95 percent cases of cardiomyopathy caused by stress. The risk factors of cardiovascular diseases in women, more often than in men, include obesity, hypertension, hypercholesterolemia and diabetes. Ischemic heart disease in women is also in many respects a different condition than ischemic disease in men.

A woman`s heart weighs less, but contracts more often, with each contraction ejecting less blood than a man`s heart. Its coronary vessels have smaller diameters, thinner walls and a winding course, and the collateral circulation is less developed. It changes less with age. Due to anatomical differences, female gender is an independent risk factor for complications after cardiac surgery.

Women and men also react differently to medications. The structure of atherosclerotic plaque is different, as is coronary reactivity, endothelial function and absorption, metabolism and distribution of chemical substances - including drugs. Inhalation of suspended dust leads to a stronger increase in blood pressure in women than in men.

Meanwhile, the participation of women in important clinical trials is much smaller than it would result from their numbers. The lack of good epidemiological studies or medical experiments on women means that they are diagnosed and treated like men.

The risk of cardiovascular events is less frequently assessed, coronary pain - more often atypical, diagnostic tests - less frequently performed and more difficult to assess, and treatment introduced later. For example, the electrocardiographic stress test often gives false positives in women.

PAP - Science in Poland, Paweł Wernicki

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