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Sex differences in cardiovascular disease risk

Wednesday January 27th 2021

Doctors often mistake the development of hypertension in women for symptoms of menopause, according to a new analysis.

A consensus document from the European Society of Cardiology has examined the influence of hormonal changes through the lifetime on women's cardiovascular disease risk.

Published in the European Heart Journal on Monday (25 January), the document states: "There are several female-specific risk factors and inflammatory risk variables that influence a woman’s risk at younger and middle age."

For example, some women are affected by gestational hypertension and diabetes, which is linked with a four-fold increase in heart failure and hypertension and a doubled risk of stroke.

Early menopause (before age 40) is also linked to a raised risk of cardiovascular disease, as are autoimmune inflammatory conditions.

The document includes updated clinical guidance compiled by an expert panel from existing evidence and the best available current practice.

First author, Professor Angela Maas of Radboud University Medical Centre, the Netherlands, says: “High blood pressure is called hypertension in men but in women it is often mistakenly labelled as ‘stress’ or ‘menopausal symptoms. We know that blood pressure is treated less well in women compared to men, putting them at risk for atrial fibrillation, heart failure and stroke.”

She adds: “A woman’s life provides clues that you need to start early with prevention. We have to assess female patients differently to men, and not just ask about high cholesterol.”

Professor Maas concludes: “There are several phases of life when we can identify subgroups of high-risk women. High blood pressure during pregnancy is a warning sign that hypertension may develop when a woman enters menopause and it is associated with dementia many decades later.

"If blood pressure is not addressed when women are in their 40s or 50s, they will have problems in their 70s when hypertension is more difficult to treat.”

Maas, A. H. E. M. et al. Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists. European Heart Journal 25 January 2021 doi: 10.1093/eurheartj/ehaa1044

[abstract]

Tags: Heart Health | UK News | Women's Health & Gynaecology

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