Heart Disease in Women

Susan C. Brozena, M.D., F.A.C.C., F.A.H.A
Disclosures		Relationship: Yes Grants/Research Support: Wyeth/Pfizer and Medtronics

Mariell L. Jessup, M.D., F.A.C.C.
Disclosures		Relationship: Yes Honorarium: Advisory Board Member for Medtronics, Acorn, Cardiomems and Ventracor

Susan C. Brozena, MD, is associate professor of medicine, University of Pennsylvania School of Medicine; and director, Heart Failure/Transplant Ambulatory Care Center, Hospital of the University of Pennsylvania (HUP). Mariell L. Jessup, MD, is a professor of medicine, University of Pennsylvania School of Medicine, and medical director of the Heart Failure/Transplant Ambulatory Care Center at HUP. Here, they discuss the factors that place women at higher risk for stroke than men, and the incidence and prevalence of heart disease in women.

The authors discuss the findings of the Nurses' Health Study defining low risk for coronary heart disease (CHD) in women, and several studies showing primary prevention and prediction factors for CHD in women. Chief of these is C-reactive protein in CHD in women. They cover the Women's Health Study which listed ten putative risk factors for vascular disease and found significantly reduced risk of CHD with simvastatin. In a large-scale National Registry of Myocardial Infarction study, women under 50 had a higher incidence of mortality than men. Moreover, several studies showed women's risk to be higher following coronary artery bypass study.

The lecture covers findings of the Women's Health Initiative in regard to risks and benefits of hormonal replacement therapy and CHD. Using several PowerPoint illustrations, the authors cover a dozen gender differences in heart failure, discuss heart transplants, and enumerate the preexisting heart diseases, including Marfan syndrome with preexisting aortic root, that carry the highest risk for heart disease in women.