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Women and Coronary Artery Disease - Topic Overview

Why is it important for women to learn about coronary artery disease?

Coronary artery disease is a leading cause of death for women throughout the world. More women die from heart disease than from cancer, chronic obstructive pulmonary disease, Alzheimer's, and accidents combined.1

But many women underestimate the threat coronary artery disease (CAD) poses to their health. And many women do not know what they can do to help prevent heart disease.

What is coronary artery disease?

Coronary artery disease is caused by the gradual buildup of plaque (made of fat, cholesterol and other substances) on the inside walls of the coronary arteries. These arteries supply oxygen-rich blood to the heart. Over time, the plaque deposits grow large enough to narrow the arteries' inside channels, decreasing blood flow to heart muscle. If the plaque becomes unstable and ruptures, inflammation and a blood clot can form at the rupture site and block blood flow, resulting in a heart attack. See a picture of how plaque causes a heart attack camera.gif.

Coronary artery disease seems to happen slightly differently in women compared to men. For example, plaque might build up differently in a woman's arteries so that a doctor cannot see a blockage during a cardiac catheterization test. Researchers are trying to understand these differences to help find the best ways to diagnose and treat women who have CAD.

What increases a woman's risk?

Women have unique risk factors for heart disease. These include pregnancy-related problems as well as medicines they may be taking, such as birth control pills or hormone therapy.

Menopause. A woman's chance of getting coronary artery disease is higher after menopause. This higher chance is not completely understood. But cholesterol, high blood pressure, and fat around the abdomen—all things that raise the risk for coronary artery disease—also increase around this time.

Hormone therapy (HT). If you have menopausal symptoms such as hot flashes and vaginal dryness, you might consider hormone therapy to relieve your symptoms. Because menopause and hormones are linked with the health of your blood vessels, you and your doctor will discuss your health and your risk of heart disease to make sure hormone therapy is safe for you. Risk for heart disease and other health problems varies based on when you start HT in menopause and how long you take it. Short-term use of hormone therapy in early menopause has less risk than when it is started later in menopause. Risk also depends on the type of HT used (estrogen or estrogen plus progestin).2

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