Despite that, every year, more women than men die from cardiovascular problems, Cardiology had not thoroughly studied the differences of the female heart.New research could save thousands of lives a year.
Nuria Saez, Sevillian 56, was an example of healthy lifestyle. Take 5 servings of fruits and vegetables a day, daily walking, going to the gym once a week, he had fifteen years without smoking ... With 1,63 m tall and 59 kg, her blood pressure was perfect and he believed , their genes augured a long life ( "only one of my four grandparents did not meet the 80 years!" he says). Against all odds, Nuria spent two years with angina (chest pain from poor blood flow to the heart). In addition, heart valves do not work well and one of its ventricles has increased in size. Today, despite medication, you can not exercise. "I do not think impending death, but I know my disease can reduce my life expectancy," says Nuria. "I also know that science advances. I am optimistic and I want to remain so, for my daughters and my granddaughter, "she said bravely.
Nuria case is unusual. If before 60 years, women have less likely than men to develop cardiovascular problems, once the disease gives the face, we have a worse prognosis. In fact, cardiovascular disease (and its sequelae of heart attacks, stroke, heart failure ...) is the leading cause of death in women, well above the breast cancer. The saddest part of the story: most improvements in diagnosis and treatment of the disease have occurred in men.
Why that disadvantage women?
The essential difference is that, until recently, the vast majority of studies were done in men and the results were not always applicable to women. Today, medicine has finally understood that a good diagnosis and treatment of heart disease in women lies in understanding their differences.Perhaps one reason why interventions bypass ( "bypass" to save arterial blockages) and balloon angioplasty (in which a balloon in the blocked artery in order to reopen inserted) does not have the same success rate in women is that your blood vessels are smaller, "explain the experts. "These vessels tend to close again more easily after such procedures." Designed according to the male body, most of the devices and equipment that were used until recently to reopen blocked vessels in women were too large.
Micro-Vascular disease
Fortunately, today has reduced the scale and success rates begin to improve.
Cases like Nuria also begin to focus the interest of science. Doctors now believe that their symptoms indicate a more common type of heart disease in women and cardiologists have barely begun to understand. Patients give abnormal stress tests and reveal a heart muscle oxygen hungry ... but, to the surprise of doctors, their coronary arteries appear perfectly clear in the contrast tests (angiograms).
Now, doctors are beginning to understand that what affects these women is what is known as micro-vascular disease: hardening or narrowing of the small arteries (arterioles) that nourish the heart, too small to be seen on angiograms. In affected patients, these arterioles have lost capacity to dilate and increase blood supply to the heart.
What's different about this disease is that the cause does not seem to be fatty deposits that block large coronary arteries. In it, the muscles of arterioles increase in size, the walls of these vessels harden and light or opening is reduced. The result is ischemia, or lack of (and oxygen) heart blood flow. Over time, it means increased risk of heart failure and heart attacks.
Studies
US health authorities who have studied the problem (called "female ischemia syndrome") estimate that at least 3 million women may have micro-vascular heart disease in that country !!. Extrapolated to Spain, the rate equivalent to almost half a million affected ...
In a recent study (the WISE study, stands for Ischemia Syndrome Evaluation Female, launched in 1998), only a third of women with symptoms of ischemia had coronary blockages .. "In comparison, up to 75% of men with the same symptoms had severe coronary blockages, "the authors said.
What do these findings mean? "You can not file a normal angiogram and quietly tell a woman with cardiac symptoms:" Go home that you do not have any problems, "says Dr. Bairey Merz, director of the Wise study. "Now we must ensure. For example, we use all available questionnaires to rule out any signs of ischemia. Also, as women with high levels of hostility are at increased risk of heart problems, we must listen and check all risk factors, including a psychological evaluation. "
And what about the high rates of cholesterol and hypertension? "The answer is that these anomalies are also involved in some way in microvascular disease, so we must treat these problems aggressively in women with chest pain," says Merz. "Also, the woman herself should seriously aware of the need for physical exercise and the dangers of snuff and excess weight."
