Coronary heart disease in women - The gender differences

Cardiovascular disease is the leading cause of death in women although many women and their physicians underestimate the risk. Women are under represented in most clinical studies, so the data and the results are less well documented for them. A number of studies have reported gender differences in clinical features and diagnosis of patients with coronary artery disease(CAD), as well as concerns about different responses to some therapies among male and female subgroups. Such disparities are well documented, however, clinical guidelines do not discriminate between men and women. Women are diagnosed later than men and receive fewer therapies, including fewer coronary angiography and revascularization and lead to worse outcomes. This article reviews gender differences of coronary artery disease in the pathophysiology, symptoms, risk factors, and also reviews current diagnosis, revascularization and prevention guidelines. Future trials should generate specific data on CAD in women, either by design of female-only studies or by subgroup analysis by sex.