Up to 50% of women with heart disease symptoms do not have the typical blocked heart arteries seen in men.  Instead the problem seems to lie in the small arteries of the heart not even seen on traditional angiograms, according to a state-of-the-art paper in a recent Journal of the American College of Cardiology.

Physicians are having to re-think our whole approach to women with heart disease symptoms but no atherosclerotic obstructions in the major heart arteries.  The "plumbing model" serves men fairly well; women, not so well.  Yearly in the U.S., more women than men die from heart disase: 455,000 versus 410,000. 

Are the higher cardiac deaths in women related to their higher average C-reactive protein levels, a marker of inflammation and predictor of heart disease?  We don't know yet.

The authors of the paper speculate that abnormal reactivity in the small heart arteries leads to poor blood flow (ischemia) to the heart muscle.  They propose the term "Ischemic Heart Disease" be applied to this phenomenon, reserving "Coronary Heart Disease" for obstructions in the large arteries.

Lead author Leslee Shaw, Ph.D., discussed the journal article in an interview. 

We have drug therapies that reduce chest pain and improve quality of life associated with small artery ischemia.  We need much more research, especially with regards to prevention of heart failure and death in women.  Recognition of the fact that heart disease in women is not the same as in men should lead to better quality research. 

But you don't have to wait years for research results.  You can start today to reduce your heart disease risk: visit NutritionData's Heart Health section. 

-Steve Parker, M.D.

References: 

Shaw, Leslee, et al.  Women and ischemic heart disease.  Journal of the American Journal of Cardiology.  54 (2009): 1,561-1,575.

Interview with the article's lead author