Heart disease in women

Heart disease in women

Heart disease is being recognized more often in women. Heart disease causes one out of three deaths in women and about half of these is due to coronary artery disease. A forty year old female has a 32% lifetime risk of heart disease. After 45 years, the overall remaining lifetime risk for cardiovascular disease up to the age of 95 years was estimated as 60.3% for males and 55.6% for females [1].

Still only about 55% of women recognize heart disease as the most important risk. Some studies mention that 52% of women developing a myocardial infarction die before reaching a hospital and 2/3rd of those with a myocardial infarction never recover fully. But women are protected from coronary heart disease prior to menopause and the average age of occurrence of the first myocardial infarction is about 8-10 years higher in females. This difference is maintained globally even though the age of first myocardial infarction is different in various regions. The risk increases as the age advances.

While men have higher risk before the fifth decade, risk is higher in women beyond the sixth decade. Hypertension, an important risk factor for coronary artery disease, is more prevalent in males before the age of 35 years while after the age of 75 years, it is more prevalent in females. Overall, hypertension is 15% more common in women and less well controlled. In women with diabetes mellitus, cardiovascular disease is twice as common and they are four times likely to be hospitalised, compared to men. There is a perimenopausal increase in LDL cholesterol and decrease in HDL cholesterol which increases the risk in postmenopausal women.

Reference

1. John T Wilkins, Hongyan Ning, Jarett Berry, Lihui Zhao, Alan R Dyer, Donald M Lloyd-Jones. Lifetime risk and years lived free of total cardiovascular disease. JAMA. 2012 Nov 7;308(17):1795-801.