Atherosclerosis - Gender difference

Cardiovascular disease develops 7 to 10 years later in women than in men and is still the major cause of death in women. The under-recognition of heart disease and differences in clinical presentation in women lead to less aggressive treatment strategies and a lower representation of women in clinical trials. Furthermore, self-awareness in women and identification of their cardiovascular risk factors needs more attention, which should result in a better prevention of cardiovascular events. It is assumed that exposure to endogenous oestrogens during the fertile period of life delays the manifestation of atherosclerotic disease in women. Although studies have shown that hormonal dysfunction in premenopausal women is associated with an increased risk of atherosclerosis and CHD events, it is still unclear whether the polycystic ovary syndrome (PCOS) is an independent risk factor for atherosclerosis.

Cardiovascular disease develops 7 to 10 years later in women than in men and is still the major cause of death in women. The under-recognition of heart disease and differences in clinical presentation in women lead to less aggressive treatment strategies and a lower representation of women in clinical trials. Furthermore, self-awareness in women and identification of their cardiovascular risk factors needs more attention, which should result in a better prevention of cardiovascular events. It is assumed that exposure to endogenous oestrogens during the fertile period of life delays the manifestation of atherosclerotic disease in women. Although studies have shown that hormonal dysfunction in premenopausal women is associated with an increased risk of atherosclerosis and CHD events, it is still unclear whether the polycystic ovary syndrome (PCOS) is an independent risk factor for atherosclerosis.

Endothelial dysfunction - Endothelial dysfunction is a systemic pathological state of the endothelium (the inner lining of blood vessels) and can be broadly defined as an imbalance between vasodilating and vasoconstricting substances produced by (or acting on) the endothelium. Endothelial dysfunction can result from and/or contribute to several disease processes, as occurs in hypertension, hypercholesterolaemia, diabetes, septic shock, and Behcet's disease.

Hyperlipidemia - At proper levels, lipids perform important functions in your body, but can cause health problems if they are present in excess. The term hyperlipidemia means high lipid levels. Hyperlipidemia includes several conditions, but it usually means that you have high cholesterol and high triglyceride levels. High lipid levels can speed up a process called atherosclerosis. Most hyperlipidemia is caused by lifestyle habits or treatable medical conditions.

Plaque characteristics - Atherosclerotic plaque formation results from complex cellular interactions in the intima of arteries, which take place between resident cells of the vessel wall (smooth muscle cells and endothelial cells) and cells of the immune system. histopathologic examinations of a large series of plaques have revealed substantial variations in the thickness of fibrous caps, in the size of atheromas, in the extent of dystrophic calcification. 

Postmenopausal Status - A woman's risk of developing atherosclerosis and heart disease increases once she reaches menopause. Prior to menopause, women are mainly protected from heart disease by estrogen, the reproductive hormone produced by the ovaries. This protection is why women tend to develop heart disease 10 years after men. However this 10-year protection is not seen in women who smoke or have diabetes. Among its many roles, estrogen helps keep arteries free from plaque by improving the ratio of LDL and HDL cholesterol. It also increases the amount of HDL cholesterol, which helps clear arteries of LDL cholesterol, the kind that most contributes to plaque build-up. Replacing natural estrogen hormones with drugs after menopause is not an effective way to prevent heart disease and may even be harmful.

  • Endothelial Dysfunction
  • Hyperlipidemia
  • Plaque Characteristics
  • Postmenopausal status

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