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His and hers heart disease.

Article Excerpt
His and hers heart disease

Mounting evidence makes a case for a gender-based approach to heart disease.

It's often been said that matters of the heart affect men and women differently. However, medical research isn't focusing on who hails from Mars and who from Venus, but on gender distinctions in earthly anatomy and physiology and their influence on heart disease.

This is a change from the first decades of clinical research in cardiology, which all but excluded women, although the lessons learned brought advances in prevention and treatment that have benefited both sexes. It's hard to blame medical researchers for overlooking women: maleness long ranked near the top of the list of risk factors, although it's in danger of losing that dubious distinction. In the United States, the annual number of deaths from cardiovascular disease (heart disease and strokes) is now greater in women than in men.

So, after years of gender-based research, it's becoming increasingly clear that gender differences should guide many aspects of heart disease prevention, diagnosis, and treatment.

Differences in risk

Men and women share a lot of the same risk factors, but there are also some important differences:

Smoking. A cigarette habit tops the list of lifestyle risk factors for men and women alike. But for women who take birth control pills, smoking increases the risk of heart attack and stroke even more.

Cholesterol. Levels of "bad" LDL cholesterol above 130 mg/dL are thought to signal even greater risk for men, while levels of "good" HDL cholesterol below 50 mg/dL are seen as greater warnings for women. High triglyceride levels (over 150 mg/dL) are also a more significant risk factor for women.

High blood pressure. Until age 45, a higher percentage of men than women have high blood pressure. During midlife women start gaining

on them and by age...