Editor’s Note: The Heart of the Matter
It’s long been known that women have gotten short shrift in terms of being screened for heart disease. Women who present to emergency rooms, as well as to their physicians’ offices, tend to be less aggressively tested and treated for heart disease than men. Women get fewer stress tests, coronary arteriograms, stents, and statin therapy for the exact same levels of disease and symptoms as men of the same age.
It should, therefore, be no surprise that women who have heart attacks tend to do worse overall. They have more advanced disease, they don’t respond as well to therapy, and they have a poorer prognosis at the time of bypass surgery. Women’s heart vessels are also smaller than men’s, and this may be another important reason that the actual treatment of heart disease should differ in women.
A recent study also shows that even younger women between the ages of 30 and 54 who are hospitalized with myocardial infarctions (heart attacks) are more likely to die in the hospital than their male counterparts. So, what does this mean for women?
Risk factors for men and women are the same (over age 50, smoking, diabetes, LDL cholesterol greater than 100, hypertension, and family history of heart disease). To ensure early diagnosis and treatment, women should demand high-level screening, including CT angiograms (CT scans looking at arteries) or stress testing, if they have two risk factors for heart disease. As with other diseases, early detection means less invasive intervention, with better quality of life and longevity. In addition, women need to have a better understanding of their own risks and be proactive by eating a heart-healthy diet, getting regular exercise, and effectively managing high blood pressure, diabetes, and high LDL cholesterol. And, don’t forget, what’s good for the heart vessels is good for the brain vessels, too: If you’re taking action to prevent a heart attack, you’re also lowering your risk of stroke.
—Editor-in-Chief Orli R. Etigin, MD
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