To My Patients, 

WOMEN AND HEART DISEASE

There is a significant sex disease in cardiovascular disease (CVD). For every major risk factor, women have a greater relative risk compared to men.

Prevention guidelines are based on risk assessment:

High Risk women: Those with evidence of heart disease, peripheral vascular disease, aneurysm, diabetes, chronic renal failure. Recommendations include blood pressure and lipid control (LDL<100) low-dose aspirin, ACE inhibitor therapy, statin therapy, omega-3 fatty acids, folate 1 mg. per day if homocysteine elevated, control diabetes, evaluate for depression.

Intermediate-risk women: Those with subclinical CVD, metabolic syndrome, family history of early heart disease in first-degree relative (age<55 in men, age<65 in women), multiple risk factors or markedly high levels of single risk factory. Recommendations include blood pressure and lipid control, consider low dose aspirin.

Low-risk women: Those with no or few risk factors. Recommendations include therapeutic life changes and individual management of risk factors.
Antioxidant supplementation is of no benefit according to recent studies.

Women with chest pain should undergo a complete systematic evaluation to exclude coronary artery disease (CAD) before ruling out other cardiac or noncardiac evaluation for chest discomfort since heart disease in women can present with subtle as well as atypical symptoms. A negative exercise stress test provides a good prognosis in women and a low likelihood of cardiac events.

Élan Medspa
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Randy Birken, MD
www.gynfo.com