The Importance of Gender Differences in the Diagnosis and Management of Cardiovascular Disease

Ciambrone, Graciana; Kaski, Juan Carlos

doi:10.2174/138161211795656945

Cited by 16 publications

(9 citation statements)

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“…Better self-awareness in women regarding identification of their cardiovascular risk factors and symptoms can improve early detection. There is evidence that CVD is underdetected in women and that there are delays in referral, hospitalization, diagnosis and invasive treatment compared to men (83)(84)(85)(86). Women with CVD living in developing countries experience specific challenges in accessing cost-effective prevention, early detection and treatment due to gender inequality, family responsibilities and the costs of seeking care.…”

Section: Bqmentioning

confidence: 99%

Alpine Skiing as Winter-Time High-Intensity Training

Stöggl

Schwarzl

Müller

et al. 2017

Medicine &Amp; Science in Sports &Amp; Exercise

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Across all exercise modes and HIT protocols, high cardiorespiratory and metabolic responses were achieved regardless of age, sex, or fitness. EE during AS can be maximized by choosing the skiing mode "short turn skiing" in combination with an HITint to prolong the duration of continuous high-intensity loading during each descent. Therefore, all exercise modes and both HIT protocols are applicable and feasible in a broad spectrum of healthy subjects.

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Section: Bqmentioning

confidence: 99%

Alpine Skiing as Winter-Time High-Intensity Training

Stöggl

Schwarzl

Müller

et al. 2017

Medicine &Amp; Science in Sports &Amp; Exercise

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“…The metabolic syndrome increases the risk of cardiovascular disease and worsens the prognosis more in women than in men [8], [9], [10], [11], [12]. Furthermore, ED seems to potentiate the negative effect of the metabolic syndrome on mortality and cardiovascular events in women [13], [14].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

et al. 2014

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BackgroundSeveral studies suggest that cardiovascular risk factors comprising the metabolic syndrome have larger effects on the development of cardiovascular disease in women than in men. A recent study in self-reported healthy subjects demonstrated a marked gender difference in endothelial dysfunction that may be an important precursor of manifest cardiovascular disease. The aim of the present study was to determine whether the association between endothelial function and cardiovascular risk factors is different in self-reported healthy women compared to self-reported healthy men.Methods and ResultsAssociations between endothelial function (flow mediated dilation, FMD, of the brachial artery measured by ultrasound), anthropometric variables, peak oxygen uptake (VO2peak), blood pressure, serum lipids, blood glucose and a questionnaire on general health and lifestyle including smoking status were studied by logistic and linear regression in 2 528 women and 2 211 men aged 20–89 years, free from self-reported cardiovascular disease. In women with hyperglycemia, endothelial dysfunction (FMD ≤0%) occurred twice as frequently as in male counterparts. The presence of the metabolic syndrome, high blood pressure and low VO2peak increased the prevalence of endothelial dysfunction more in women than in men.ConclusionEndothelial dysfunction is more strongly associated with cardiovascular risk factors in self-reported healthy women than in self-reported healthy men. This finding could explain why the metabolic syndrome, and especially hyperglycemia, is associated with higher cardiovascular risk and a worse prognosis in women.

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“…[ 15 16 17 ] Numerous studies have proven that significant sex-related differences exist not only in the incidence and prognosis of atherosclerosis disease but also in the accuracy of different clinical examination methods. [ 18 19 20 ] Anatomic and physiological differences, including body composition, heart rate, coronary calcium level, and coronary diameter between women and men, may affect the diagnostic performance of MSCT. As we know, Eastern women have even smaller body sizes.…”

Section: Discussionmentioning

confidence: 99%

Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

Jin

Zhao

Chen

2016

Chinese Medical Journal

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Background:Multislice computed tomography (MSCT) coronary angiography (CAG) is a noninvasive technique with a reported high diagnostic accuracy for coronary artery disease (CAD). Women, more frequently than men, are known to develop atypical angina symptoms. The purpose of this study was to investigate whether the diagnostic accuracy of MSCT in women with atypical presentation differs from that in men.Methods:We enrolled 396 in-hospital patients (141 women and 255 men) with suspected or proven CAD who successively underwent both MSCT and invasive CAG. CAD was defined as any coronary stenosis of ≥50% on conventional invasive CAG, which was used as the reference standard. The patients were divided into typical and atypical groups based on their symptoms of angina pectoris. The diagnostic accuracy of MSCT, including its sensitivity, specificity, negative predictive value, and positive predictive value (PPV), was calculated to determine the usefulness of MSCT in assessing stenoses. The diagnostic performance of MSCT was also assessed by constructing receiver operating characteristic (ROC) curves.Results:The PPV (91% vs. 97%, χ2 = 5.705, P < 0.05) and diagnostic accuracy (87% vs. 93%, χ2 = 5.093, P < 0.05) of MSCT in detecting CAD were lower in women than in men. Atypical presentation was an independent influencing factor on the diagnostic accuracy of MSCT in women (odds ratio = 4.94, 95% confidence intervals: 1.16–20.92, Walds = 4.69, P < 0.05). Compared with those in the atypical group, women with typical angina pectoris had higher PPV (98% vs. 74%, χ2 = 17.283. P < 0.001), diagnostic accuracy (93% vs. 72%, χ2 = 9.571, P < 0.001), and area under the ROC curve (0.91 vs. 0.64, Z = 2.690, P < 0.01) in MSCT diagnosis.Conclusions:Although MSCT is a reliable diagnostic modality for the exclusion of significant coronary artery stenoses in all patients, gender and atypical symptoms might have some influence on its diagnostic accuracy.

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The Importance of Gender Differences in the Diagnosis and Management of Cardiovascular Disease

Cited by 16 publications

References 0 publications

Alpine Skiing as Winter-Time High-Intensity Training

Alpine Skiing as Winter-Time High-Intensity Training

Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

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