Cardiovascular Disease

Abstract

Health Issue: Cardiovascular disease (CVD) is the leading cause of death in Canadian women and men. In general, women present with a wider range of symptoms, are more likely to delay seeking medial care and are less likely to be investigated and treated with evidence-based medications, angioplasty or coronary artery bypass graft than men. Key Findings:In 1998, 78,964 Canadians died from CVD, almost half (39,197) were women. Acute myocardial infarction, which increases significantly after menopause, was the leading cause of death among women.Cardiovascular disease accounted for 21% of all hospital admissions for Canadian women over age 50 in 1999. Admissions to hospital for ischemic heart disease were more frequent for men, but the mean length of hospital stay was longer for women.Mean blood pressure increases with age in both men and women. After age 65, however, high blood pressure is more common among Canadian women. More than one-third of postmenopausal Canadian women have hypertension.Diabetes increases the mortality and morbidity associated with CVD in women more than it does in men. Depression also contributes to the incidence and recovery from CVD, particularly for women who experience twice the rate of depression as men.Data Gaps and Recommendations: CVD needs to be recognized as a woman's health issue given Canadian mortality projections (particularly heart failure). Health professionals should be trained to screen, track, and address CVD risk factors among women, including hypertension, elevated lipid levels, smoking, physical inactivity, depression, diabetes and low socio-economic status.

A Multisite Examination of Sex Differences in Cardiac Rehabilitation Barriers by Participation Status

“…For example, women may have a spouse with health problems for whom they provide care, may provide care to grandchildren, and often take the main responsibility for household chores 28 . Women more often suffer from comorbidities 40,48 such as osteoporosis, diabetes and urinary incontinence, which can all serve as deterrents to exercise in CR programs 28,30,33,34 due to fear of falling, concerns regarding foot care and accidents respectively.…”

Macrophage depletion suppresses sympathetic hyperinnervation following myocardial infarction

“…Thirty-three female Sprague-Dawley rats (60 days old, ~200 g, Harlan Breeding Laboratories) were anesthetized by intraperitoneal injection of 60 mg/kg ketamine, 8 mg/kg xylazine, and 0.4 mg/kg atropine. To minimize the influence of reproductive hormones and also to simulate postmenopausal conditions that are associated with reduced cardioprotective effects [24, 30], ovaries were removed by flank incisions [67]. Seven days after ovariectomy, rats were anesthetized as above, respired mechanically, and the left anterior descending coronary artery was ligated with silk suture as described previously [26, 51].…”

Sympathetic hyperinnervation and inflammatory cell NGF synthesis following myocardial infarction in rats

“…Ovariectomy eliminates potentially confounding effects of reproductive hormones which can influence both cardiovascular innervation and wound healing (Gillardon, et al, 1991;Saleh and Connell, 2000;Ashcroft and Ashworth, 2003;Gilliver, et al, 2003). Moreover, it simulates postmenopausal conditions in which post-infarction mortality increases dramatically (Grace, et al, 2004).…”