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Cardiovascular diseases: are women different?

Risk Factors, Epidemiology, Rehabilitation and Sports Cardiology

The session was divided into four groups than can summarise the main topics in cardiovascular diseases and the impact in women.

The possible protection of women to coronary heart disease has been discuss by Dr. Eva Swan who emphasized the presence of more than one risk factor in women, non mortality differences in young women compared to young men, major incidence of normal coronary arteries after AMI could be explained by a major activity of platelets in women and the need to revise the indications for revascularization looking at the results.

Diastolic Heart Failure is prevalent in women, as reported by Prof. Vera Regitz-Zagrosek, and systolic HF has better prognosis in women, with more concentric LVH with pressure overload and better regression after surgery and less fibrosis. The roles of E2 inhibits fibrosis and collagen synthesis in female cardiac fibroblasts and of ER interaction with major growth regulating pathways in the human heart.

Dr. Linda Gillam gave a vision of the current information about valvular heart disease and sex. The incidence of bicuspid valve is higher in men and degenerative mitral valve is more frequent in women and the surgical results are different in the short term than long term.

Pulmonary Hypertension is equal for both genders before puberty, said Dr. Nazzareno Galie, but is getting worse for women after puberty and estrogens are linked with this predisposition, even though males have a high rate of mortality. He emphasized that PAH is a contraindication for pregnancy because of the risk of maternal death.

The common message is to increase the number of studies to clarify the differences and update the indications of management in all fields with the current evidence. Avoid bias in diagnosis and treatment in women and men; and stimulate cardiologists to work on it.




Cardiovascular diseases: are women different?

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.