Women and Heart Disease

It probably won't surprise you if I say that men and women are different . It turns out that they are very different in many ways that are not obvious consequences of their sexual difference. This poses a problem for the diagnosis of diseases that manifest themselves differently in women compared to men. Not all physicians are trained well enough to recognize the different symptoms in women. Aside from the symptoms, there are significant differences in the prevalence of the major causes of mortality in men and women.

The right-hand figure shows the relative mortality risk for cancer and heart disease (the two dominant killer illnesses) in men and women. (The data is taken from the U.S. National Vital Statistics Report, v 69, no. 11, 2001). In men, up to age 70, the risk of mortality from heart disease is about equal to that of cancer. For older aged men, the heart risk continues to increase, whereas the cancer risk decreases. For women up to age 75, the risk of cancer mortality exceeds that of heart disease by a large factor. For women older than 75, heart disease is the primary cause of mortality. Over their lifetime, women have an overall risk of 31% to die from heart disease, compared to 22% from cancer. In men the corresponding numbers are 31% from heart disease and 25% from cancer. This does not explain why

• Men worry about cholesterol, PSA tests and colonoscopies, and

• Women worry about pap smears, mamograms, and to a lesser extent about heart disease

Considering one's entire lifetime, heart disease is the primary killer of women, just as it is of men! Even at an age younger than 70, it would not be responsible to ignore the impact of coronary diseases on women, that are responsible for many untimely deaths.

In the following, we will elaborate on research that has been done (and research that still needs to be done) concerning heart disease in women.

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