What Can Be Done to Prevent Coronary Heart Disease in Women?
Despite the decrease in coronary heart disease (CHD) mortality in the US in the past 30 years, CHD is the leading cause of death in men and women. Cardiovascular disease, including CHD, kills nearly 500,000 American women each year. In women, the development of CHD can be delayed by an average of 10 years compared with men, and, on average, women can experience a first myocardial infarction 20 years later than men. While CHD prevalence rates are similar in black men and white men, heart disease is not color-blind in women. Black women generally have a higher prevalence of CHD risk factors and a higher death rate at a younger age than white women. A strong family history of early onset of heart disease, increasing age, and race are unalterable factors that raise the risk of CHD. The major factors that can be modified include cigarette smoking, hypertension, diabetes mellitus, physical inactivity, obesity, dyslipidemia, estrogen level changes after menopause, and psychosocial stressors. CHD is a multifactorial process; the hazard posed by one particular risk factor is significantly influenced by other risk factors that are present, and no individual risk factor is essential or sufficient to cause CHD.
Haan
CK
Division of Cardiothoracic Surgery, University of Tennessee.