Women and Ischemic Heart Disease: Recognition, Diagnosis and Management
Korean Circulation Journal
;
: 433-442, 2016.
Artículo
en Inglés
| WPRIM
| ID: wpr-134759
ABSTRACT
Cardiovascular disease is one of the most frequent causes of death in both males and females throughout the world. However, women exhibit a greater symptom burden, more functional disability, and a higher prevalence of nonobstructive coronary artery disease (CAD) compared to men when evaluated for signs and symptoms of myocardial ischemia. This paradoxical sex difference appears to be linked to a sex-specific pathophysiology of myocardial ischemia including coronary microvascular dysfunction, a component of the 'Yentl Syndrome'. Accordingly, the term ischemic heart disease (IHD) is more appropriate for a discussion specific to women rather than CAD or coronary heart disease. Following the National Heart, Lung, and Blood Institute Heart Truth/American Heart Association, Women's Ischemia Syndrome Evaluation and guideline campaigns, the cardiovascular mortality in women has been decreased, although significant gender gaps in clinical outcomes still exist. Women less likely undergo testing, yet guidelines indicate that symptomatic women at intermediate to high IHD risk should have further test (e.g. exercise treadmill test or stress imaging) for myocardial ischemia and prognosis. Further, women have suboptimal use of evidence-based guideline therapies compared with men with and without obstructive CAD. Anti-anginal and anti-atherosclerotic strategies are effective for symptom and ischemia management in women with evidence of ischemia and nonobstructive CAD, although more female-specific study is needed. IHD guidelines are not "cardiac catheterization" based but related to evidence of "myocardial ischemia and angina". A simplified approach to IHD management with ABCs (aspirin, angiotensin-converting enzyme inhibitors/angiotensin-renin blockers, beta blockers, cholesterol management and statin) should be used and can help to increases adherence to guidelines.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Pronóstico
/
Enfermedad de la Arteria Coronaria
/
Enfermedades Cardiovasculares
/
Colesterol
/
Prevalencia
/
Mortalidad
/
Causas de Muerte
/
Caracteres Sexuales
/
Isquemia Miocárdica
/
Angina Microvascular
Tipo de estudio:
Estudio diagnóstico
/
Guía de Práctica Clínica
/
Estudio de prevalencia
/
Estudio pronóstico
/
Investigación cualitativa
Límite:
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Korean Circulation Journal
Año:
2016
Tipo del documento:
Artículo
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