Coronary artery disease (CAD) is among of the most common conditions affecting the heart. Although CAD (also known as “coronary heart disease”) affects both men and women, there is some scientific evidence suggesting that women may be at greater risk, due to female hormones and other biological differences.
According to the American Heart Association, CAD is the leading cause of death in the United States for both men and women. However, more women than men die of the condition, and more women have died of CAD than of cancer, respiratory disease, Alzheimer’s disease, and accidents combined.
According to Cardio Smart, an American college of cardiology, women’s risk of developing CAD is higher than that of men because they have specific risk factors for heart disease. These include pregnancy problems and certain medications, such as birth-control pills or hormone therapy.
Important women risk factors include:
Menopause
A woman’s chance of getting CAD becomes higher after going through menopause. Researchers have not yet managed to explain the link in any definite way. However, the menopause generally increases cholesterol, high blood pressure, and fat surrounding the abdomen, which could be connected to increased CAD risk.
Hormone therapy (HT)
When women suffer from menopausal symptoms, including hot flushes and vaginal dryness, they might take hormone therapy to relieve these symptoms, and this may affect the risks of CAD in some cases. However, the risks vary according to the timing and duration of HT regimes, as well as whether the therapy involves oestrogen or oestrogen-plus-progestin. The various studies conducted on the topic can seem contradictory, but in general, short-term use of HT in early menopause leads to reduced risk of CAD. Meanwhile, long-term use of HT in late menopause may increase the risk of CAD.
Birth control pills:
Using birth control pills might increase the risk of CAD among women who smoke and are older than 35, or if they have a family history of atherosclerosis or blood-clotting disorders. Healthy, young, non-smoking women have reduced risk of CAD when they take low-doses of birth control pills.
Problems related to pregnancy:
A problem during pregnancy called preeclampsia has been linked to a higher risk of CAD later in life. Experts are studying whether other pregnancy-related problems are linked to heart disease. Women should inform their doctor of any problems they may have experienced during pregnancy.
Immune diseases
Some immune-related diseases such as lupus and rheumatoid arthritis have been linked with an increased risk of CAD in women.
Common risk factors for women and men
Risk factors for coronary artery disease that are common in both women and men include smoking, diabetes, obesity, lack of exercise, and family history. However, in many cases, women are more likely to develop CAD as a result of these risk factors than men.
For example, women with type-2 diabetes are twice as likely to develop CAD than male type-2 sufferers, according to a scientific statement released recently by the American Heart Association in the journal Circulation.
Judith G Regensteiner from the University of Colorado School of Medicine in Denver and chair of the statement-writing group, said cardiovascular disease may be more deadly for women with type-2 diabetes than for men. The statement said women with type-2 diabetes suffer from heart-attacks younger than men. They are also more likely to die after a first heart-attack than men and are less likely than men to undergo procedures to open clogged arteries, such as angioplasty or coronary artery bypass grafting.
The statement added that Hispanic and African-American Hispanic women with type-2 diabetes are disproportionately affected by CAD and stroke compared to men with type-2 diabetes.
While the data for the research on type-2 diabetes was gathered from patients in the United States, the findings may be particularly significant for Egypt, which has a high incidence of type-2 diabetes.
