Fw: : Men and Women Are NOT Equal When it Comes to Heart Disease

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What Every Woman Should Know About Heart Failure!


Heart failure is a major cause of disability and death in both men and women. 
Over the last few decades, significant resources have been dedicated to 
understanding what causes it, and to developing better treatments for it. And 
significant strides have been made.
 
One thing that we have discovered is that many aspects of heart failure differ 
between men and women. For both sexes, heart failure comes about as a result of 
coronary artery disease, or chronic hypertension (high blood pressure). 
Usually, the symptoms of heart failure, and the treatment of it, are similar in 
men and women, but there are some differences.

There are a few aspects of heart failure that pertain especially to women. 
These include the causes of heart failure in women, the age of women who 
develop heart failure, the symptoms caused by the heart failure, and how 
doctors treat heart failure in women. If you’re a woman who has heart failure, 
you should make sure you know these differences.

Causes of Heart Failure That Are Especially Important in Women 

Hypertension
The most common medical problems that lead to heart failure are hypertension 
and coronary artery disease (CAD). Of these, hypertension is the leading cause 
in both sexes. However, hypertension is substantially more likely to cause 
heart failure in women than in men. Hypertension increases the risk of 
developing heart failure by 300% in women, but “only” 200% in men. Among women 
with heart failure, hypertension is the underlying cause in 59% of cases in 
women, compared to 39% in men. So while it’s important for anyone with 
hypertension to be treated adequately, it’s even more so for women.

Diastolic Heart Failure
In diastolic heart failure, cardiac function deteriorates because the heart 
muscle becomes stiff, and the heart has difficulty filling with blood. As a 
result, the amount of blood that is pumped around the body with each beat is 
significantly reduced (making you tired and exercise intolerant), and the blood 
that is unable to fill the heart “backs up” into the lungs (producing pulmonary 
congestion). While this condition can occur in anyone, it’s more prominent in 
women than men.

Diabetes
Diabetes by itself doesn’t cause heart failure, but people with diabetes have a 
high incidence of conditions that do, such as CAD and hypertension. 
Furthermore, for reasons that are not understood, women with diabetes are twice 
as likely to develop heart failure than men with diabetes.
Obesity  
Women who are obese have a high risk of developing heart failure that is 50% 
higher than women who are normal weight. Obese men also have a higher risk of 
heart failure, but the excess risk from obesity is not thought to be as high in 
men as it is in women.

Chemotherapy
Certain drugs used for chemotherapy can cause cardiac toxicity that can lead to 
heart failure. Women tend to be exposed to these chemotherapy agents a lot more 
often than men, in particular, for the treatment of breast cancer...

Stress Cardiomyopathy
Stress cardiomyopathy, also known as “broken heart syndrome,” is a form of 
sudden, severe heart failure that is triggered by extreme emotional trauma. 
While this condition can be found in either sex, it’s far more common in women, 
and may be related to microvascular angina – a condition that is more common in 
women.

Age of Women with Heart Failure
Women who develop heart failure usually do so at an older age than men who 
develop heart failure. Unfortunately, as past clinical trials tended to exclude 
people over the age of 65, this means that relatively little data has been 
collected from clinical trials showing how older women with heart disease 
respond to treatment. Recently, researchers have been including a sufficient 
number of elderly women in their clinical trials, and this shortcoming is 
slowly being rectified.

Symptoms of Heart Failure in Women

As mentioned previously, the symptoms of heart failure in men and women are 
largely the same – gradually worsening fatigue, dyspnea, exercise intolerance, 
and edema. However, some scientific studies suggest that women with heart 
failure are more likely to experience significant dyspnea and edema than men.
Response to Treatment in Women  
As stated, clinical trials evaluating the treatment of heart failure have 
tested considerably more men than women. Nevertheless, the data that is 
available strongly suggests that women with heart failure respond to treatment 
just as favorably as men.

Differences in How the Hearts of Men and Women Respond to Cardiac Stress

In studies with animals and in clinical trials, evidence is accumulating to 
suggest that the heart muscles of men and women react differently to various 
kinds of physiologic stress.. Several animal studies have looked at how the 
hearts of males and females react to experimental conditions that have been 
designed to produce heart failure. These studies have consistently shown that 
female cardiac muscle tends to respond by making various adaptions that help to 
prevent heart failure, whereas male cardiac muscle fails more quickly.

Clinical trials on people have shown the same thing. In those with aortic 
stenosis (a narrowing of the aortic valve, which greatly increases the pressure 
and stress in the left ventricle), premenopausal women develop cardiac 
hypertrophy (thickening of the heart muscle) more readily than men. This 
hypertrophy reduces wall stress, delays the onset of dilated cardiomyopathy and 
thus, reduces the risk of heart failure. Interestingly, postmenopausal women do 
not show this same adaption, and they develop heart failure at the same rate as 
men, suggesting that female hormones may play a part. However, clinical trials 
evaluating this have given contradictory results.

These findings may help to explain why women develop heart failure later than 
men, and why women who have heart failure tend more often to have diastolic 
heart failure than men.

Still, having said this, all we can say with confidence at the moment is that 
the hearts of men and women respond somewhat differently to various kinds of 
physiological stress.
Outcome of Heart Failure in Women  
Evidence suggests that, even though they usually develop heart failure at a 
later age than men, women with heart failure tend to survive longer than men.

This relatively good news for women who have heart failure is counter-balanced 
by some clinical evidence that suggests that doctors tend to be less aggressive 
when treating women with heart failure when compared with men. One reason for 
this may be that women may tend to minimize their cardiac symptoms when talking 
to their doctors. Those doctors who do not push their patients for a full 
accounting of symptoms may not be aware of just how sick their female patients 
actually are.

Therefore, it’s very important for anyone, male or female, who has symptoms of 
heart failure – especially worsening fatigue or dyspnea – to make sure their 
doctors are aware of it. But, maybe women need a little extra reminding of how 
important it is.
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