Women's Heart Health: Difference between revisions

Hypertension is a highly prevalent risk factor that becomes more common in women then in men and is particularly prevalent among black women.<cite>8</cite> After menopause the renine activity in plasma increases which leads to sodium retention. By the age of 60 almost 50% of all women have clinically manifest hypertension, defined as a systolic blood pressure > 140 mmHg and a diastolic blood pressure of 90 mmHg.<cite>9</cite> Hypertension in women compared to men more often leads to CVA, left ventricular hypertrophy en diastolic dysfunction. The structural changes of the myocardium can become clinical manifest by dyspnea, supraventricular tachycardia such as atrial fibrillation, angina due to endothelial dysfunction. Slightly elevated blood pressure leads in women more then in men to endothelial dysfunction.<cite>10</cite> Hypertension is 2 to 3 times more common in women taking oral contraceptives, especially among obese and older women. Blood pressure lowering strategies have demonstrated to reduce the risk of ischemic heart disease and stroke

In women there is a stronger fluctuation of lipid levels throughout life. Due to hormonal changes total and LDL cholesterol levels increase with an average of 10-14% after menopause.<cite>11</cite> Low HDL and high triglycerides seems to be more important risk factors in women than in men. Data from the Nurses Health Study shows that HDL was the lipid parameter that best discriminated the risk of ischemic heart disease.<cite>12</cite>

Hypertriglyceridemia is associated with a 37% increase in CVD risk in women compared to 14% in men.<cite>13</cite> The dynamic changes of the lipidprofiles due to age and menopausal status play an important role in the prevention of cardiovascular disease in women.  

Estrogens improve the arterial wall response to injury and inhibit the development of atherosclerosis by promoting re-endotheliazation, inhibiting smooth muscle cell proliferation and matrix deposition following vascular injury. They also have a vasodilative effect. Premenopausal women with hormonal dysfunction and estrogen deficiency have a higher risk for developing premature atherosclerosis.<cite>14</cite> The polycystic ovarian syndrome, a condition also known as PCOS have a high risk for developing the metabolic syndrome and type 2 diabetes and are therefore  an at risk population. Also women with premature ovarian failure (menopause before the age of 40) have a higher risk for developing CVD.

#2 [http://www.bhf.org.uk/publications/view-publication.aspx?ps=1001443 Steven Allender, Peter Scarborough, Viv Peto and Mike Rayner ''European cardiovascular disease statistics 2008'', British Heart Foundation Health Promotiona Research Group.]

#7 [http://cardiovascres.oxfordjournals.org/content/90/1/9.full Viola Vaccarino, Lina Badimon, Roberto Corti, Cor de Wit, Maria Dorobantu, Alistair Hall, Akos Koller, Mario Marzilli, Axel Pries and Raffaele Bugiardini ''Ischaemic heart disease in women: are there sex differences in pathophysiology and risk factors?'' 2010]

#15 Eur.H J/2006;27:2285-93