Gender Issues in CVD

Question 1

T/F incidence of MI is higher among men but mortality is higher in women

Answer 1

T

Question 2

T/F women have more obstructive coronary artery disease than men

Answer 2

F –> less

*women present later, risk factors undertreated, less likely to be diagnosed, low ses, older age

Question 3

Positive effects of estrogen on CV system

Answer 3

1. decrease LDL
2. increase HDL
3. better NO vasodilation
4. inhibits vascular injury response so less atherosclerosis

–> post menopause increase in CVD among women

Question 4

Negative effects of estrogen on CV system

Answer 4

1. increase TG
2. increase inflammatory markers
3. prothrombotic

Question 5

T/F estrogen has different effects in vessels with atherosclerosis than non-atherosclerotic vessels

Answer 5

T –> fewer estrogen receptors –> confounds results of women’s health initiative study which demonstrated no real CV benefit of estrogen (cohort was a bunch of post-menopausal women who might have had some atherosclerosis already)

Question 6

T/F smoking in younger women poses greater risk than in men

Answer 6

T –> estrogen interaction

Question 7

T/F women with stemi have worse outcomes than men

Answer 7

T –> but do better when have USA

Question 8

T/F there is no therapeutic difference in reducing mortality among women/men with STEMI

Answer 8

T

Question 9

T/F women die more with CABG operations

Answer 9

T

Question 10

Hemodynamic effects of pregnancy

Answer 10

1. increase plasma volume, RBC –> difference between these two = anemia of pregnancy
2. increase CO, SV, HR
3. reduced TPVR
4. increased lower extremity venous pressure

Question 11

Hemodynamic effects of labor

Answer 11

1. increase blood in circulation w/contractions = increase CO, BP
2. blood loss
3. increase in venous return

Question 12

Highest CV risk of pregnancy

Answer 12

pulmonary hypertension, dilated cardiomyopathy, obstructive lesions/aortic stuff (stenosis, coarcts, etc)