Epidemiology of coronary heart disease in women

The male excess in coronary heart disease (CHD) is well recognised. Hypertensive heart disease icd 10 Nevertheless, CHD is the leading cause of death in women as well as men in most industrialised countries. Prevention of congenital heart disease 1 , 2 , 3 , 4 In the United Kingdom in 2002, coronary heart disease accounted for approximately 64?000 (22%) of the 288?000 deaths or one in five deaths in men, and 53?000 (17%) of the 318?000 deaths, or one in six death in women at all ages. Is congestive heart failure heart disease 1 , 2 , 3

CHD MORTALITY RATES, INTERNATIONAL COMPARISONS AND TIME TRENDS

Table 1 ? 1 shows mortality rates for CHD by age and sex in the United Kingdom and also the ratio in men compared to women.


Cornary heart disease The male excess for CHD is most pronounced at younger ages but still apparent throughout life. 3 vessel coronary artery disease Age standardised CHD mortality rates by sex for selected countries between 1999–2000 are shown in fig 1 ? 1 , 2 , 3 illustrating enormous international variations. Ischemic heart disease guidelines The highest documented rates are now seen in countries in Eastern Europe with women in these countries having over 10?fold the rates of women in Japan. Facts on heart disease A male excess in CHD is evident in all countries; nevertheless, the CHD rates in men and women internationally correlate strongly. Heart disease screening Time trends for selected countries from 1969 to 2001, 2 , 3 shown in fig 2 ? 2 illustrate different patterns in these countries. Rheumatic heart disease medications Both the United States and United Kingdom have had notable declines in CHD rates in three decades. Risk for heart disease In contrast, CHD rates in women in Eastern European countries such as the Ukraine, or developing countries such as Mauritius, have increased over a similar time period. Ischemic heart disease meaning The profound temporal trends indicate that the major determinants of mortality rates are likely to be potentially modifiable environmental factors rather than genetic susceptibility.

Numerous factors have been implicated in the aetiology of CHD. Coronary heart disease age 4 Of these, the role of the classical risk blood cholesterol concentrations, blood pressure and cigarette smoking have been the best documented in both men and women. Left coronary artery disease Mean levels of these risk factors increase with age, more steeply in women than in men. How do you get heart disease At younger ages, women tend to have lower mean levels of systolic blood pressure and serum cholesterol compared to men; this pattern reverses at older ages. Coronary heart disease possible causes In contrast, cigarette smoking habit appears to decline with age in both men and women. Congenital heart disease ribbon Though the prevalence of smoking is higher in older men, the most recent figures show higher prevalence of smoking in younger women compared to men. Heart disease and diet 3 , 5

The evidence for the major importance of raised blood cholesterol for CHD in both men and women is overwhelming. Congenital heart disease in babies Raised blood pressure, fibrinogen values, cigarette smoking habit, diabetes, inflammatory markers such as C?reactive protein, and obesity are also well documented risk factors in women. Coronary heart disease death rate Of these, reduction of blood pressure and cholesterol have been demonstrated to be of cardiovascular benefit in randomised trials which have included women. Signs of congestive heart disease 6 The classical risk factors—blood pressure, raised blood cholesterol and cigarette smoking—appear to confer the same relative increase in CHD risk in women and some of the sex difference in CHD can be explained by lower levels of risk factors in women, at least at younger ages. Cost of heart disease In particular, cigarette smoking habit has been substantially lower in the past in women compared to men, but trends appear to be reversing in younger cohorts. What are the causes of heart disease Some of the apparent protection that women seem to have from CHD may diminish as prevalence of cigarette smoking in women increases and even exceeds that in men.

While the magnitude of the relative risk of subsequent CHD associated with the major risk factors are similar in men and women, the absolute risk of CHD is higher in men compared to women at any given level of risk factor. Atherosclerotic heart disease 7 , 8 This has implications for individual?based preventive therapies such as pharmacologic treatment of hypertension and hypercholesterolaemia. Valvular heart disease pathophysiology Though trials indicate these confer similar relative benefits for CHD in men and women, the absolute benefit is likely to be lower in women. Rheumatic heart disease mitral stenosis Thus, the risk?benefit balance may be different and more finely balanced in women compared to men when individual preventive treatments are considered.

Lifestyle factors, diet, physical activity, and psychosocial factors in CHD may have effects through influencing levels of known physiological risk factors such as lipid values and blood pressure or through other mechanisms involved such as inflammation or thrombosis. Congenital heart disease definition Though there are few randomised trials of primary prevention of CHD using lifestyle measures in women, it may seem reasonable to assume from the consistency in the data from observational studies that similar lifestyle factors apply to women as well as men. Signs of heart valve disease Observational studies in women as well as men indicate lower CHD rates are associated with dietary patterns with lower saturated fat intake, higher fruit and vegetable intake and higher physical activity levels. Rheumatic heart disease etiology 6

Despite obvious differences in concentrations of endogenous sex hormone, the assumption that women have less CHD than men because either high oestrogen concentrations are protective or high testosterone concentrations are adverse for CHD is not well supported by available evidence. Congenital heart disease journal This evidence is derived from either observational studies of endogenous hormone values or from more recent postmenopausal hormone replacement therapy trials such as the Women’s Health Initiative, which showed no benefits for CHD with oestrogen supplementation with or without progestogen. Congenital heart disease murmurs 9 , 10 , 11 , 12

The international variations and time trends in CHD rates in women indicate that a substantial proportion of CHD in women can be prevented. Coronary heart disease risk equivalent Rates in women closely correlate with rates in men, suggesting that the environmental and lifestyle factors that lead to high CHD rates in men also lead to high rates in women. What is a heart disease Population based approaches which aim to modify lifestyle factors such as diet, smoking and physical activity are likely to benefit both men and women. Causes of congenital heart disease The observation that women in countries with high CHD rates have over sixfold the rates in men living in countries with low CHD rates indicates that environmental influences far outweigh the impact of any biologic differences between men and women in CHD susceptibility. Pictures of heart disease Though women have lower CHD rates than men, CHD is the leading cause of mortality in women as well as men in most industrialised countries. Hypertensive heart disease ppt Preventive interventions need to be targeted at women as well as men.

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