“He is more susceptible to drugs.”
He myocardial infarction It increases “gradually in younger women and women over 65,” said Dr. Luis Castilla, coordinator of the vascular risk group at the Spanish Society of Internal Medicine (SEMI).
At the 20th SEMI Vascular Risk Meeting, the doctor explained that the incidence of myocardial infarction without coronary artery obstruction “increases in women under 60 years of age.” Thus, at a meeting held in Malaga, he noted that one of the most common public health problems is increase in cardiovascular diseases (CVD) as they are “the first cause of death for women and the second cause of death for men in Spain.”
Exactly, as confirmed by the Commission on Women and CVD LancetThese diseases remain “understudied, underrecognized, underdiagnosed, and undertreated.”
During the meeting, experts presented some of the biological differences between men and women. They have provided several examples so far. Among them, women have a “lower prevalence of obstructive atherosclerotic coronary disease” and are more likely to suffer from single-vessel disease, microvascular dysfunction with microcirculatory changes, coronary vasospasm and coronary artery dissection.
In addition, the expert added that Estrogens are involved in vasodilation and improve “endothelial function through nitric oxide,” but exogenous administration of sex hormones “showed no benefit.”
Women, in turn, have more complications after invasive coronary intervention or surgery get around coronary artery and more often suffer from “diastolic heart failure (HF) with normal systolic function” and “concentric ventricular hypertrophy with preserved ejection fraction,” he said.
They are also more susceptible adverse effects of drugs. These include digoxin, beta blockers, angiotensin-converting enzyme inhibitors, and diuretics, which increase the risk of cardiac arrhythmias. On the other side, Men They are more likely to experience “stenoses of the coronary trunk and multiple vascular lesions, and more often develop heart failure with reduced ejection fraction and eccentric hypertrophy with an enlarged ventricle.”
In which group does it occur most often?
As Dr. Castilla explained, thanks to the various studies conducted, they were able to see and show differences in the symptomatic manifestations of coronary heart disease, being more common in women “more nonspecific vagal symptoms (nausea, dizziness, epigastric discomfort),” different from those in men, meaning that “they sometimes do not identify their symptoms as cardiac or important and delay seeking medical attention.”
In addition, she noticed how long it takes a woman to see a doctor from the first symptoms to seeing a doctor. In this sense, he argued that prioritize other household and caregiving responsibilities before going to the emergency department.
Besides, in women undergo fewer invasive tests and there are typically fewer diagnoses, fewer imaging studies, fewer angiographies, and more complications.
There is also a long delay in conducting diagnostic tests after consultation. In the same way, receive fewer heart transplants and cardiac rehabilitation, among other differences, is indicated to a much lesser extent.
Finally, the expert stated that women undergo fewer diagnostic examinations in the acute phase of a stroke and are treated less often than men with tissue plasminogen activator, antiplatelet agents and anticoagulants.
Cardiovascular risk factors
For risk factors, SEMI has detailed that women have a higher risk of acute myocardial infarction associated with hypertension, hypercholesterolemia and diabetes than men.
In addition, they also noted obesity as a major concern, since excess cardiovascular risk is higher “in women than in men”, as well as the increased risk of cardiovascular diseases associated with smoking, which is 25 percent higher in women than in men. On the other side, passive lifestyle associated with a higher risk of cardiovascular disease, in turn “higher in girls and women than in men”
In addition, as emphasized throughout the meeting, it is very important to highlight specific factors such as premature menopause, gestational diabetes, hypertensive disorders of pregnancy, premature birth, polycystic ovary syndrome, systemic inflammatory diseases and autoimmune disorders; and underrecognized risk factors such as psychosocial risk, intimate partner violence against women, socioeconomic deprivation, low health literacy, and environmental risk factors.