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    Women's Heart Risk May Go Unnoted

    Stay Vigilant, Even if Tests Look Clear, Researchers Say
    By
    WebMD Health News
    Reviewed by Louise Chang, MD

    Jan. 31, 2006 -- Women should take good care of their hearts, even if their arteries look clear of major blockages, heart experts say.

    Heart disease is a leading cause of death for men and women alike. Symptoms can differ between the sexes, scientists report in the Journal of the American College of Cardiology.

    The researchers sum up years of research on women and heart disease. Findings came from the WISE (Women's Ischemia Syndrome Evaluation) study, which started in 1996.

    A type of heart disease called coronary microvascular syndrome, which is more common among women than men, was one of the WISE study's topics.

    In the syndrome, plaque spreads out along the arteries instead of forming major blockages. Those arteries may look clear in medical tests but still carry a high risk of heart attack. Such tests are still worthwhile for women, but they may not paint the whole picture of a woman's heart risk, the WISE study suggests.

    Women's Undiagnosed Heart Risk

    "When a diagnosis of this condition is missed, women are not treated for their angina [chest pain] and high cholesterol and they remain at high risk for having a heart attack," says Elizabeth G. Nabel, MD, in a news release.

    Nabel directs the National Heart, Lung, and Blood Institute (NHLBI), a branch of the National Institutes of Health.

    "This study and the high prevalence of coronary microvascular dysfunction demonstrate that we must think out of the box when it comes to the evaluation and diagnosis of heart disease in women," says Nabel.

    In other words, women and men both need to tend to heart health, but the tests and methods might not overlap completely.

    Women's Risks, Men's Risks

    Heart disease has usually been studied in men.

    "So much of our understanding of the underpinnings of heart disease and heart attack, and the basis for our standard methods of diagnosis and treatment, are the result of research conducted on men," says C. Noel Bairey Merz, MD, in the news release.

    Merz works at the Cedars-Sinai Medical Center in Los Angeles and led the WISE study.

    "Through clinical experience, many critical questions arose about how the disease may manifest differently in women, and how diagnostic techniques may need to be used differently in order to prevent more heart attacks and save lives," Merz says.

    "Too often women are tested again and again, go untreated, and still have high risk for heart attacks," says George Sopko, MD, NHLBI project officer for WISE, in the news release. He adds that WISE made "tremendous progress" in understanding women's heart disease.

    Doctors "must systematically examine women for evidence of any blockages and initiate intensive treatment for their risk factors," Sopko says.

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