Women Are Said to Face Hidden Heart Disease Risk

[Guest guest]

In light of especially Cheney's

( http://www.dfwcfids.org/medical/cheney/heart04.htm )

Myhill's ( http://www.cfids-cab.org/MESA/DrMyhill-373.pdf &

http://www.drmyhill.co.uk/article.cfm?id=373 ) & Peckerman's

( http://www.cfids-cab.org/MESA/Lerner.html ) as well as Rich Van Konynenburg

( http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0509c & L=co-cure & P=1585 )

cardiomyopathy comments, among others, regarding CFS, ME, & FM etc ....

I thought this was interesting.

I seem to have been collecting these articles. The forth url above has

several links on it regarding this issue.

Blessings

Shan

Women Are Said to Face Hidden Heart Disease Risk

http://www.nytimes.com/2006/02/01/health/01heart.html?_r=1 & th & emc=th &

oref=slogin

By DENISE GRADY

Published: February 1, 2006

Women are more likely than men to have a hidden type of coronary disease (

http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/hear\

t

disease/index.html?inline=nyt-classifier ) in which their heart muscle is

starved for oxygen even though their coronary arteries look clear and free of

blockages on X-rays, doctors are reporting.

The condition, which may affect three million American women, greatly

increases the risk of a heart attack. Its main symptom is chest pain or

discomfort.

In many women, the pain occurs but nothing shows up on an angiogram, a test in

which dye is injected into the coronary arteries and they are X-rayed in a

search for blockages, so doctors conclude that no treatment is needed.

But patients may then go on to have heart attacks or develop heart failure, a

weakening of the heart muscle that can be debilitating and ultimately fatal.

" When there are no blockages, everybody slacks off, including the patient,

and we don't want to do that, " said Dr. Sopko of the National Heart, Lung

and Blood Institute. Such patients almost certainly need treatment, he said.

The best way for a woman to find out whether she has the artery disease is to

undergo tests, including certain type of stress tests, that measure blood

flow to the heart. But not everyone needs to be tested; women with symptoms, a

family history of heart disease or severe risk factors may be candidates.

The findings are among those in a series of articles to be published today in

two medical journals — the Journal of the American College of Cardiology, and

Circulation — exploring the differences in heart disease between men and

women. The subject has drawn increasing interest in recent decades, as

scientists

began to realize that the results of previous studies, done mostly in men, did

not always apply to women.

Among the differences already known are that women with heart disease tend to

be sicker than men by the time it is diagnosed, to benefit less from bypass

surgery and to have more severe symptoms when they develop heart failure. Some

of the difference is because women are older and frailer when they develop

heart disease, but that does not account for all of it.

Symptoms of heart attack also tend to differ. Men report crushing pain in the

chest, while women are more likely to feel dizzy, sick, short of breath and

sweaty.

Heart disease, strokes and other cardiovascular diseases are the leading

causes of death in the United States and other developed countries. They killed

910,600 people in the United States in 2003, the most recent year for which data

are available; more than half the deaths, 484,000, were among women.

Although women's risk is greatest after menopause (

http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/meno\

pause/index.html?inline=

nyt-classifier ) and increases with age, heart disease is the No. 1 cause of

death in all women older than 25. Overall death rates from coronary disease

have declined in the past few decades, but most of the improvements have been in

men's rates.

The cause of the hidden disease being described today is a diffuse buildup of

fatty deposits inside the walls of the coronary arteries and in the very

small arteries in the heart. The deposits, or plaques, do not show up as

blockages

on X-rays, but they still interfere with blood flow and can damage the heart

muscle, causing ischemic heart disease. ( " Ischemia " means " inadequate blood

flow. " )

But often the condition is not recognized, and the women are told they have

nothing to worry about. Instead, Dr. Sopko said, they should be treated

aggressively for other problems that lead to artery disease like high

cholesterol,

high blood pressure and diabetes. If necessary, he added, they should also be

advised to quit smoking, lose weight and exercise more.

The researchers report that compared to a nonsmoker, a woman who smokes has a

risk of dying from heart disease equal to the risk she would have if she

weighed 90 pounds more than the nonsmoker.

" To women as patients, the message is, look, if you have symptoms, don't

think because you are a woman you are immune to having a heart problem, " Dr.

Sopko

said.

The findings are based on a government-sponsored study called Wise, for

Women's Ischemia Syndrome Evaluation. Begun in 1996, it included 936 women who

had

symptoms that led doctors to order angiograms. The women's average age was

about 58, but a quarter were young enough to be premenopausal.

Despite their symptoms, only a third of the group had obvious blockages in

their coronary arteries. In a similar group of men, three-quarters or more would

have a severe blockage, said Dr. Carl J. Pepine, the chief of cardiovascular

medicine at the University of Florida in Gainesville and one of the lead

investigators in the Wise study.

In the remaining two-thirds of the women — that is, those without blockages

—

more than half had abnormalities in their arteries, like an inability to

dilate when needed, that could cause ischemia, Dr. Pepine said. The

abnormalities

occurred in both the coronary arteries and smaller ones that feed the heart,

a network of tiny vessels called the microvasculature.

Tests showed that the artery walls were full of plaque but had grown outward

to accommodate it, so that the opening appeared normal. But, eventually, the

condition may progress enough to start pinching the artery shut, Dr. Pepine

said.

After four years, the rate of deaths or heart attacks in the group without

blockages was 10 percent.

" That's much too high for somebody with a normal coronary angiogram, " Dr.

Pepine said.

It is not clear why women seem more prone to the hidden vascular disease, the

researchers said, though it may be linked to hormonal imbalances and a

greater tendency to suffer from inflammation, which plays a role in artery

disease.