Heart disease in women - sex differences

The cardiovascular disease is the leading cause of death among women. This article reviews the current literature on the gender-related differences in the diagnosis and treatment of cardiovascular disease and healthcare implication. The stable angina is more common as an initial presentation of coronary disease in women. The women despite higher risk characteristics are investigated and treated less aggressively than men. The women are not referred for stress testing because of the high rate of false positives and rare to alternative stress imaging technique. Gender differences exist in acute coronary syndrome (ACS) in terms of clinical profiles, presentation and outcome. Women with ACS are older and have more co morbid factors. The lack of significant chest pain may be a major reason why women have more unrecognized ACS. A smaller percentage of women than men had infarction with ST elevation. Women had more complications than men during hospitalization. These differences reflect pathophysiologic differences between men and women. Women undergoing coronary revascularization procedures have a higher risk for an adverse outcome compared with men. Risk factors for development of heart failure also differ by sex. Hypertension and diabetes mellitus have a greater role in women. Heart failure with preserved systolic function - "diastolic dysfunction" - is more common in women. It is important to identify gender-related differences in management of cardiovascular disease to improve healthcare of women.