ReviewCardiovascular diseases in American women
Section snippets
Incidence
National Heart, Lung, and Blood Institute-sponsored Atherosclerosis Risk in Communities Cohort (ARIC) study (1987–2001) indicated that the average annual rates of the first CVD events were 1.4, 3.3, 6.9 and 10.7 per 1000 women for the age groups 45–54, 55–64, 65–74 and 75–84, respectively [2]. For men, the corresponding numbers were 2.8, 5.4, 10.5 and 14.4. The rates for women were close to that of men 10 years younger.
Mortality
There is an overall reduction in the death rate due to CVD in the United States in the past several decades. However, the decrease is less for women than for men and less for African-American women than for white women [3], [4]. Since 1984, the number of CVD deaths for women has exceeded those for men (Fig. 1). Women represent 52.6% deaths of CVD [1]. In the United States in 2005, a total of 454 613 women died of CVDs while 268 890 women died of all forms of cancer. CVD as the underlying cause
Risk factors
Cigarette smoking, hypertension, dyslipidaemia, diabetes mellitus, obesity, sedentary lifestyle and poor nutrition are important risk factors for CVD in women. There are disparities for risk factor by ethnicity. Black women had the highest obesity prevalence in women (47.3%). Black women also had the highest hypertension prevalence (51.2% for women without a high school education and 37% for women with high school or higher education) among all women [6]. Some communities of American Indian
Coronary heart disease
Today, there are about 3.2 million women having a history of myocardial infarction (MI) or heart attack [1]. The first event of coronary heart disease (CHD) occurs about 10 years later in women than in men, especially after menopause [9]. Although women had a marked advantage in age-specific risk of CHD, the greater life expectancy of women produces nearly equal numbers of actual deaths due to CHD in men and women [10].
Stroke
Stroke is a serious health-care burden for United States. It is the third leading cause of death in this country following heart disease and cancer. It is the leading cause of serious, long-term disability. Today, there are 2.7% of men and 2.5% of women aged 18 years or older who have had a history of stroke.
Heart failure
There are about 2.5 million women today who have survived heart failure. For men and women, the number of hospital discharge for heart failure continued to increase from 877,000 in 1979–1,106,000 in 2006. Women had a higher number of hospital discharge than men each year during this period [1] (Fig. 2). Another report from the hospitals in Worcester, Massachusetts, indicated that women had a higher heart failure incidence rate than men (250 and 194, respectively, per 100,000) [34]. It is
Risk factor
Age is an important non-modifiable risk factor for CVD in both men and women. Although the prevalence in women was lower than in men younger than 40 years, it increased rapidly later in a woman's life. By the fifth and sixth decade of life, prevalence in men and women equalized and, in the following decades, women have higher prevalence than men [1].
Another non-modifiable risk factor for CVD is family history. In a small number of families, predisposition of CHD is monogenic, with transmission
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Estrogen inhibits renal Na-Pi Co-transporters and improves klotho deficiency-induced acute heart failure
2021, Redox BiologyCitation Excerpt :We hypothesized that a reduction of hyperphosphatemia by low phosphate diet may prevent the cardiac remodeling and heart failure in Klotho-deficient mice. The women population has a lower risk of heart disease [14]. However, the sex difference in the risk of heart disease disappears after age 65 14.
Mercury induces nuclear estrogen receptors to act as vasoconstrictors promoting endothelial denudation via the PI3K/Akt signaling pathway
2019, Toxicology and Applied PharmacologyAssociations between intensive diabetes therapy and NMR-determined lipoprotein subclass profiles in type 1 diabetes
2016, Journal of Lipid ResearchCitation Excerpt :Given that the average age of menopause in the USA is 51 years (46), it is likely that most of our female subjects (mean age 26.2 years at sample collection) were premenopausal. Premenopausal women usually have a lower risk of CVD compared with men in the same age group (47, 48), but women with type 1 diabetes lose this protection (49–52). The reason for this loss of protection against CVD among young type 1 diabetic women is not fully understood.
Cardiovascular disease prevention in women: A rapidly evolving scenario
2012, Nutrition, Metabolism and Cardiovascular DiseasesCitation Excerpt :However, in recent years, CVD has also gained recognition as a global public health burden [6–11], with the largest number of deaths occurring in low- and middle-income countries [63]. While the bulk of the AHA recommendations are likely to apply to most settings and populations worldwide, there is an obvious need to shape preventive efforts based on specific demands and resources available across different geographic locations, also accounting for the rapidly evolving epidemiological trends of CVD and the changing prevalence of major CVD risk factors across different populations [6–11]. In addition, most of the evidence, which informs current guidelines for CVD prevention in women [12], comes from industrialized countries; therefore, additional observational and clinical research would be desirable from other populations around the world.
Cardiac rehabilitation for women across the lifespan
2012, American Journal of MedicineCitation Excerpt :However, after menopause, HDL cholesterol significantly decreases in women, and its cardioprotective effects diminish. Independent of the shifts in HDL, low-density lipoprotein (LDL) levels often remain lower in women than men at any age.33-35 Based on these differences in LDL, many women do not qualify for statin therapy based on traditional National Cholesterol Education Program treatment cutpoints.36