Chapter 24 - Coronary heart disease

Summary

Coronary heart disease (CHD) is the single leading cause of death of American women. Age is the biggest risk factor for CHD. The onset of CHD in women lags about 10 years behind men. Although most risk factors for CHD are similar in men and women, gender differences have been documented, particularly related to diabetes and dyslipidemia. The gradual decrease in estrogen levels related to menopause has been implicated in the rise of CHD risk occurring with advancing age in women. Aspirin reduces the incidence of subsequent MI, stroke, and death from cardiovascular causes by 25% in women and men with established vascular disease. Women were more likely than men to have unstable angina rather than acute myocardial infarction. Health care providers need to be aware of gender differences in presentation, prognosis, and responsiveness to treatment of CHD in order to optimize patient care.