Source: Thailand Medical News Jan 07, 2020 4 years, 9 months, 2 hours, 12 minutes ago
Statistically more
women than men die of
heart failure. The reason is that only 50 percent of the
heart failure cases among
women are caused by having a
heart attack, which can be treated with modern methods.
In the case of the remaining other half of
women experiencing
heart failure, the cause is generally related to having untreated high blood pressure levels over time, which leads to progressive stiffening of the
heart. There is no effective treatment for this kind of
heart failure yet.
Professor Dr Eva Gerdts, Department of Clinical Science, University of Bergen told
Thailand Medical News, "Men and
women have different biologies and this results in different types of the same
heart diseases. It is about time to recognize these differences."
Dr Gerdt added, "Another important point concerning how to avoid
heart disease is to ask about what the national health service is doing on this issue.
Heart disease remains among the most common cause of death and reduced quality of life in
women. Medically speaking, we still do not know what the best treatment for
heart- attack or -
failure is in many
women. It is an unacceptable situation."
Dr Gerdts has recently published an invited review paper in
Nature Medicine together with Professor Vera Regitz-Zagrosek at Charité Universitätsmedizin.
The medical researchers have compared common risk factors for
heart disease and how these affect men and
women differently. They have, among other things, focused on the sex differences in the effect of obesity, high blood pressure and diabetes.
Statistically, according to World Health Organization (WHO) 11 percent
women and 15 percent men are obese (BMI over 30 kg/ m
2) globally. In Norway one in five adults are obese.
Dr Gerdts pointed out,"If we see this from a life span perspective, we can see that obesity increases with age, and that this trend is greater for
women than men. Obesity increases the risk of having high blood pressure by a factor of three. This, in turn, increases the risk of
heart disease."
Obesity also increases the risk of diabetes 2. A
woman with diabetes has a much higher relative risk of
heart complications and death than a man, according to Dr Gerdts."We know that
women with diabetes 2 are usually obese and some of this fat is stored in the
heart, which makes it more vulnerable for disease."
Dr Gerdts explains that many of the difference
s between
woman and men when it comes to
heart disease are connected to the sex hormone, estrogen. The hormone prevents the formation of connective tissue in the
heart, which makes it harder for the
heart to pump. In men the effects are the opposite.
She added, "We see that obese men store estrogen in their fat cells in the abdomen, which has a bad effect on the
heart."
Typically, after menopause,
women lose the estrogen advantage. Their arteries becomes stiffer and more vulnerable for disease. We see this in the fact that for persons under 60, high blood pressure is most common amongst men. For persons over 60, it is the opposite. "We think that this is part of the explanation for why high blood pressure seems to indicate higher risk of
heart disease amongst
women," Dr Gerdts said.
Furthermore, smoking is also a part of the risk scenario for
women. During the past decades, more
women have started smoking than men."Many
women start smoking to reduce their appetite and to control their weight. However, this is not a good choice from a health perspective. For
women, the effects of risk factors such as smoking, obesity and high blood pressure increase after menopause." says Dr Eva Gerdts.
Reference : Eva Gerdts et al. Sex differences in cardiometabolic disorders, Nature Medicine (2019). DOI: 10.1038/s41591-019-0643-8