TOPIC FOUR: CVD IN WOMEN Flashcards
_/3 women over 65 are affected by CVD
1
How much later do women develop symptoms of CVD compared to men
10-15 years later
How many women report discussion CV health with their doctor
1/3
What is the cause for the most deaths in Canada for women
Heart disease and stroke
How is the prevalence of HTN related to men and women and age
At younger ages, the prevalence of HTN is slightly lower in women than men
For women age 65+ is when there is a switch to the prevalence being higher in women than men - maybe has to do with menopause
How is the prevalence of heart failure related to men and women and age
Heart failure is more common among men than women ages 60-79, but 80+, there is a big shift to it being more common in women than men
Which is more important in men and women as a cute for heart failure
Ischemic heart disease/HTN
What is it likely to cause
What is LV diastolic dysfunction
HTN is more important cause in women, while ischemic heart disease is more important in men
HTN likely to cause LV diastolic dysfunction (impaired relaxation)
- Left ventricular diastolic dysfunction – inability for the left ventricle to relax, cant fully fill and pump properly to the body
- Worse outcomes for women with HF (i.e., depression)
- More women experience depression with HF compared to men
Do women often recognize heart attacks?
There are a lot of unnoticed heart attacks by women!
20,30,40%
Facts
Women are ___ likely to receive preventative treatment than men
Less
Facts
When treatment is prescribed, to women treatment is ___ aggressive
Less
Facts
Women ___ likely to participate in cardiac rehab
Less
Lack of referrals for women for M.Ds
Facts
Women are ___ less likely to be enrolled in CR
36%
Enrollment in cardiac rehab is favouring men
Traditional risk factors for CVD
Diabetes Smoking Obesity and overweight Physical inactivity Hypertension Dyslopidemia
Non traditional risk factors for CVD
Preterm delivery
Hypertension disorders of pregnancy
Gestational Diabetes
Autoimmune disease (lupus)
Breast cancer treatment (radiation might alter the heart because of its location close to the breast being treated) - can lead to hypertrophy and remodelling
Depression - can cause chronic inflammation which may link to heart disease. There is also an increase in hypothalamus pituitary axis which is acted when we have fight or flight response - activated in chronic stress state as well
Impact of gestational diabetes on CVD
Women with gestational diabetes are at a higher risk of CVD events
What is preeclampsia and how is it related to HTN
Preeclampsia is pregnancy induced hypertension
Women with pre-eclampsia are 4X more likely to take HTN mediation later on in life and 3X more likely to take medication for dyslinpidemia
What are steroid hormones
Hormones derived from cholesterol (ex. estrogen and testosterone) that are lipid soluble
How to steroid hormones entre cells
Pass from the blood to the cytoplasm of the cell (right through, lips soluble so does not need to go through a channel)
What happens when a steroid hormone is inside the cell
binds to a receptor within the cell forming a hormone receptor complex
The hormone receptor complex enters the nucleus and changes genetic transcription (change in enzymes, receptors and functions of ion channels)
What is aromatase
An enzyme that converts testosterone to estrogen
Do cardiomyocytes express aromatase
yes
How does aromatase related to CVD
Aromatase deficiency seems to accelerate atherosclerosis
Do cardiomyocytes have estrogen receptors?
Yes
Estrogen (alpha receptors) might play the most dominant role in cardiovascular health
Do both men and women experience increase in testosterone during puberty
Yes
