A new study conducted by the Medical University of South
Carolina suggests that women and men are facing different heart risks even
though the amount of coronary plaque is similar between the sexes (Salamon,
2011). Plaque is plaque, right? According to this recent study, women were
found to have higher risks of major cardiac events when a significant amount of
plaque build-up was present—which led to the hardening of the arteries
(Salamon, 2011). Alternatively, men had a greater risk of myocardial infarction
when their arteries contained plaque that was considered “non-calcified” or
fatty deposits that can accumulate in the walls of the arteries (Salamon, 2011).
The study involved 480 patients—two-thirds were women—with
acute chest pain that were given coronary CT angiographies which examined the
presence of coronary artery blockages (Salamon, 2011). Using this non-invasive
test, researchers were able to determine the number of blood vessel segments
with plaque, the severity of the blockage and the composition of the plaque
(Salamon, 2011). Then, a 13-month follow up analysis was performed on each
individual (Salamon, 2011). In the follow-up, several patients had major
cardiac events. The presences of these extreme cardiac events were significant
in comparing the content of the plaques observed in the patients—calcified,
non-calcified, or combination. Some of the cardiac events included heart
attack, unstable angina, or bypass surgery. In conclusion, the study found that
women had greater risks of cardiac events when a large amount of plaque
build-up was present, while men had a greater risk when their arteries contain
plaque that was “non-calcified”—fatty deposits accumulation in the walls of the
arteries.
Also, atherosclerosis—artery hardening—is believed to differ
in how it is deposited in men and women. Coronary atherosclerotic plaques are
mainly distributed with highly variable rates of progression—alterations in
wall shear stress have been studied to contribute to the distribution and pathophysiology
of coronary atherosclerosis (Samady et al, 2011). Experimental studies propose
that low wall shear stress promotes plaque development while high wall shear stress
is associated with plaque deterioration (Samady et al, 2011).
With the different deposited plaques in men and women, the
Medical University of South Carolina’s current study believes that different risks
come with the different content of those plaques (Salamon, 2011). In consideration, the study did involve a decent sample
size but the tested individuals were mostly female. This developmental
difference in plaque formation and composition serves great importance in the
treatment of cardiac issues for males and females. If there is a significant
difference and these differences play a role in the increased cardiac risks,
then this knowledge is important for the current and future treatment of
cardiac problems—for men and women.
Salamon, Maureen (2011). Clogged arteries pose different
dangers for men, women. HealthDay, at USA Today website.
http://yourlife.usatoday.com/health/story/2011-12-01/Clogged-arteries-pose-different-dangers-for-men-women/51544118/1.
Samaday, Habib, et al. Coronary artery wall shear stress is
associated with progression and transformation of atherosclerotic plaque and
arterial remodeling in patients with coronary artery disease. Circulation,
127(7), 16 August 2011, pages 779-788. http://ovidsp.tx.ovid.com.
I find this study very interesting especially how it displays an important theme often found in medicine. This theme is sex discrimination in research. When I was becoming an EMT we were repetitively warned that many of the warning signs and symptoms of certain diseases and events were biased, and that our book did not in fact give many of the symptoms that were seen in practice...for women. For a long period of time men and women were considered to be generally the same physiologically,and therefore diseases represent equally across the sexes. Unfortunately this caused much research to be performed on only one sex, males (although some reversal bias is now being seen), and this research was then indiscriminately applied to women. No problem right? The sexes are basically the same in things like heart attacks, I mean hearts are no different across the sexes, there is no differences between male and female...Except apparently there are a vast amount of physiological differences between men and women...
ReplyDeleteEver heard that a sign of a heart attack is pain radiating down your left arm? Most have. How about that jaw pain or a heavy feeling on your chest can also be a sign of myocardial infarction? Most haven't. The first symptom is common for men, and not for women, while the second is a primary sign of MI for women. Even though MI is common and just as dangerous in women, the symptoms are relatively unknown to the majority of the population. Unable to recognize symptoms can lead to the occurrence and progression of many preventible issues and dangers.
As shown in this plaque study as well as the link I have posted, there are differences even in the way that MI risk factors present themselves. Each of the sexes needs to be treated and diagnosed differently, and symptoms need to be defined and clarified separately.
http://www.aafp.org/afp/2001/0401/p1290.html