Women and Heart Disease

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Female Arrhythmia Problems

This week my friend Brett Newcomb and I are continuing our discussion of the gender differences between men and women. We are spending time talking about the issues of medical research and making distinctions in research populations based on gender. For many years, men were the primary population for medical research. In part this was due to FDA restrictions on including women of child bearing age in medical research populations. A failing of these restrictions was that we did not develop enough consistent data to define differences in the way men and women metabolized medicines, or were susceptible to varying diseases like heart disease. We now know that there are indeed many such differences.

At the risk of making all my cardiologist friends out there crazy, I am over simplifying my explanations. I want to make a point to women that there are known differences and talk a little about what some of those are, regarding the heart disease risks of women. One thing we have learned is to interview women about symptoms differently than we do men. Women manifest the indicators of heart problems differently than men do. For one thing, women tend to have a mitral valve prolapse more often than men, and men tend to have atherosclerosis. Another gender based difference has to do with the fewer numbers of women who suffer from hypertension. This is in part due to the estrogen that women have and that men do not. As a result, men tend to get hardening of the arteries more frequently than women and they are more hypertensive.

Other concerns for women and their doctors regarding treatments of heart disorders and cardiovascular disease is one about medications. Generally because of the seize differences, but sometimes because of other genetic factors, the dose for a 6’0’’ tall and 190 lb. male would be way to much medicine for a 5’2”, 120 lb. female. Doctors have to know how to regulate the dose and give the proper amount of medicines. It is helpful that we have finally begun to include women of all ages in our research protocols so that we can change the lab results with regard to the normal scores for men and women. This way, the medically recommend dose can be more accurately determined based on an individual person, be it male or female. This is more progress than we have made on the lab test results for “normal” thyroid readings. We have known for many years that there are “normal” for thyroid results for men and for women. But the standard lab report form used by the major labs in the United States, do not list a normal for women. Doctors just have to know and adjust their prescriptions accordingly.

Obviously, from the few examples I have given, this can be dangerous at the most, and incredibly irritating at the lease, when doctors and women do not have the information to identify properly the gender differences for diseases, medical dosages, and treatment protocols. We are having this discussion today not just to inform you, but to make you an activist in determining that your doctor and your lab can and do identify your situation accurately based on your gender. It matters to all of us. As always, thank you for following our podcast.