Angina in Women
Ischemic heart disease has been shown to equally affect men and women, albeit the condition becomes manifest approximately a decade later in women compared with men. Among the elderly, the absolute number of women affected by angina pectoris is greater th
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Abstract Ischemic heart disease has been shown to equally affect men and women, albeit the condition becomes manifest approximately a decade later in women compared with men. Among the elderly, the absolute number of women affected by angina pectoris is greater than that in men. Moreover, mortality rates associated with cerebrovascular and cardiovascular disease are higher in women compared with men, and recent observations indicate that while mortality appears to be declining in men this is not the case among women. Cardiovascular disease is now recognized as the leading cause of death for women in developed countries worldwide and is more common than death from cancer, HIV, malaria and tuberculosis combined. The prevalence of angina pectoris in the absence of obstructive CAD is higher in women compared with men. Hypertension is more prevalent in elderly women than in men and this has been suggested to represent an explanation for the higher prevalence of stroke and heart failure with preserved ejection fraction in women compared with male patients. Similarly, studies have reported that women with type 2 diabetes have a higher risk of cardiovascular mortality than women with no diabetes and diabetic men. The differences in clinical outcome between men and women have been attributed to a greater prevalence of risk factors, inflammation, diffuse coronary atherosclerosis and small vessel disease, in diabetic women than in diabetic men. Differences in diagnostic strategies and treatment J.C. Kaski, Essentials in Stable Angina Pectoris, DOI 10.1007/978-3-319-41180-4_5, © Springer International Publishing Switzerland 2016
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Chapter 5. Angina in Women
disparities, favouring men, may represent another important factor. These issues will be discussed in this chapter.
Introduction In recent years it has become apparent that ischemic heart disease (IHD) equally affects men and women [1–3], albeit the condition becomes manifest approximately a decade later in the latter [4, 5]. Among the elderly, the absolute number of females with angina pectoris is greater than that of males [4]. Moreover, mortality rates associated with cerebrovascular and cardiovascular disease are higher in women compared with men [2, 3], and recent observations indicate that while mortality appears to be declining in men this is not the case among women [4]. The important topic of angina in women has been recently reviewed by F Crea et al. [6] and by K. Schenck-Gustafsson [7].
Epidemiology Prevalence For several years it has been known that stable angina is the most common initial symptomatic presentation of IHD among women [8]. Cardiovascular disease is now recognized as the leading cause of death for women in developed countries worldwide and is more common than death from cancer, HIV, malaria and tuberculosis combined [9]. It is estimated that 50 % of deaths among women are associated with heart disease or stroke, while 1 in 25 die of breast cancer [10, 11]. This is contrary to perception among patients and physicians that women are not so
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