One
thing that we have discovered is that many aspects of heart failure
differ between men and women. For both sexes, heart failure comes about
as a result of coronary artery disease, or chronic hypertension (high
blood pressure). Usually, the symptoms of heart failure, and the
treatment of it, are similar in men and women, but there are some
differences.
There are a few aspects of heart
failure that pertain especially to women. These include the causes of
heart failure in women, the age of women who develop heart failure, the
symptoms caused by the heart failure, and how doctors treat heart
failure in women. If you’re a woman who has heart failure, you should
make sure you know these differences.
Causes of Heart Failure That Are Especially Important in Women
Hypertension
The most common medical problems
that lead to heart failure are hypertension and coronary artery disease
(CAD). Of these, hypertension is the leading cause in both sexes.
However, hypertension is substantially more likely to cause heart
failure in women than in men. Hypertension increases the risk of
developing heart failure by 300% in women, but “only” 200% in men. Among
women with heart failure, hypertension is the underlying cause in 59%
of cases in women, compared to 39% in men. So while it’s important for
anyone with hypertension to be treated adequately, it’s even more so for
women.
Diastolic Heart Failure
In diastolic heart failure, cardiac
function deteriorates because the heart muscle becomes stiff, and the
heart has difficulty filling with blood. As a result, the amount of
blood that is pumped around the body with each beat is significantly
reduced (making you tired and exercise intolerant), and the blood that
is unable to fill the heart “backs up” into the lungs (producing
pulmonary congestion). While this condition can occur in anyone, it’s
more prominent in women than men.
Diabetes
Diabetes by itself doesn’t cause
heart failure, but people with diabetes have a high incidence of
conditions that do, such as CAD and hypertension. Furthermore, for
reasons that are not understood, women with diabetes are twice as likely
to develop heart failure than men with diabetes.
Obesity
Women who are obese have a high
risk of developing heart failure that is 50% higher than women who are
normal weight. Obese men also have a higher risk of heart failure, but
the excess risk from obesity is not thought to be as high in men as it
is in women.
Chemotherapy
Certain drugs used for chemotherapy
can cause cardiac toxicity that can lead to heart failure. Women tend
to be exposed to these chemotherapy agents a lot more often than men, in
particular, for the treatment of breast cancer.
Stress Cardiomyopathy
Stress cardiomyopathy, also known
as “broken heart syndrome,” is a form of sudden, severe heart failure
that is triggered by extreme emotional trauma. While this condition can
be found in either sex, it’s far more common in women, and may be
related to microvascular angina – a condition that is more common in
women.
Age of Women with Heart Failure
Women who develop heart failure
usually do so at an older age than men who develop heart failure.
Unfortunately, as past clinical trials tended to exclude people over the
age of 65, this means that relatively little data has been collected
from clinical trials showing how older women with heart disease respond
to treatment. Recently, researchers have been including a sufficient
number of elderly women in their clinical trials, and this shortcoming
is slowly being rectified.
Symptoms of Heart Failure in Women
As mentioned previously, the
symptoms of heart failure in men and women are largely the same –
gradually worsening fatigue, dyspnea, exercise intolerance, and edema.
However, some scientific studies suggest that women with heart failure
are more likely to experience significant dyspnea and edema than men.
Response to Treatment in Women
As stated, clinical trials
evaluating the treatment of heart failure have tested considerably more
men than women. Nevertheless, the data that is available strongly
suggests that women with heart failure respond to treatment just as
favorably as men.
Differences in How the Hearts of Men and Women Respond to Cardiac Stress
In studies with animals and in
clinical trials, evidence is accumulating to suggest that the heart
muscles of men and women react differently to various kinds of
physiologic stress. Several animal studies have looked at how the hearts
of males and females react to experimental conditions that have been
designed to produce heart failure. These studies have consistently shown
that female cardiac muscle tends to respond by making various adaptions
that help to prevent heart failure, whereas male cardiac muscle fails
more quickly.
Clinical trials on people have
shown the same thing. In those with aortic stenosis (a narrowing of the
aortic valve, which greatly increases the pressure and stress in the
left ventricle), premenopausal women develop cardiac hypertrophy
(thickening of the heart muscle) more readily than men. This hypertrophy
reduces wall stress, delays the onset of dilated cardiomyopathy and
thus, reduces the risk of heart failure. Interestingly, postmenopausal
women do not show this same adaption, and they develop heart failure at
the same rate as men, suggesting that female hormones may play a part.
However, clinical trials evaluating this have given contradictory
results.
These findings may help to
explain why women develop heart failure later than men, and why women
who have heart failure tend more often to have diastolic heart failure
than men.
Still, having said this, all we
can say with confidence at the moment is that the hearts of men and
women respond somewhat differently to various kinds of physiological
stress.
Outcome of Heart Failure in Women
Evidence suggests that, even
though they usually develop heart failure at a later age than men, women
with heart failure tend to survive longer than men.
This relatively good news for
women who have heart failure is counter-balanced by some clinical
evidence that suggests that doctors tend to be less aggressive when
treating women with heart failure when compared with men. One reason for
this may be that women may tend to minimize their cardiac symptoms when
talking to their doctors. Those doctors who do not push their patients
for a full accounting of symptoms may not be aware of just how sick
their female patients actually are.
Therefore, it’s very important
for anyone, male or female, who has symptoms of heart failure –
especially worsening fatigue or dyspnea – to make sure their doctors are
aware of it. But, maybe women need a little extra reminding of how
important it is.
this is only for your
information, kindly take the advice of your doctor for medicines,
exercises and so on.
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Labels: CAD( coronary artery disease), chemotherapy, chronic HP, diabetes, diastolic failure, difference, dyspnea, edema, emotional trauma, heart attacks, men, microvascular angina, obesity, stress cardiomyopathy, women
