Heart disease is the number one killer of women. Every year it kills more women than men. In 1996, the last year for which we have full data, heart disease killed over 50,000 more men than women or about 506,000. During this same period, cancer claimed the lives of about 258,000 women.
Women are more likely than men to die of a heart attack. For years it was assumed that this was because women were sicker when brought to the attention of the doctor. Now it is thought that the difference is really due to a difference in the disease in men and women.
Because of differences in men and women, the same diagnostic tests may not detect the disease in women and they may be told that the pain in their chest is really in their head. The Women's Ischemia Syndrome Evaluation, a study of 1,000 women in Florida, Alabama, and Pennsylvania, has found that women with chest pain and other heart disease symptoms may appear fine on some standard tests.
Plaque in women's arteries is often in a "lumpy-bumpy pattern." In men, the plaque appears more like a pimple that breaks and leads to a clot. In women, doctors see a malformation that looks like a scar.
Women are more prone to arterial spasms. During the spasm, the lining of the blood vessel rubs together, causing it to erode or wear away. This leads to the formation of clots. In men, doctors see a complete blockage of an artery to the heart. In women, there are partial blockages along the length of the artery. When a spasm occurs, the artery is then blocked.
Heart disease in women has many of the same risk factors and causes-high blood pressure, high cholesterol, smoking, obesity. But hemoglobin level and inflammation also appear to play a role. One thing has become apparent from these results. The same treatments may not be effective in women.
New research is looking at not only the differences in disease between men and women but new ways of diagnosing that difference and new ways to treat this "women's disease".