Ischemic heart disease, a focus on the female population

Abstract

Cardiovascular disease (CVD) is the main cause of mortality worldwide in women, however, there is a lack of knowledge of this reality, since most of the prevention programs in women have been directed towards breast, cervical and ovaries cancer. Emerging evidence supports that ischemic heart disease differs between the sexes. Despite this, women have been underrepresented in scientific research and the results for men are extrapolated, without considering the existing differences in risk factors, coronary anatomy, pathophysiology, symptoms, and diagnosis. Women have a unique ischemic heart disease phenotype, where approximately 60% of female patients presenting with symptoms and signs suggestive of ischemia do not have obstructive coronary lesions, have a higher prevalence of microvascular disease compared to men, have less calcification of plaque and are more likely to have formation of thrombus. Given these pathophysiological differences, diagnostic studies should ideally assess the full spectrum of ischemic heart disease. Therefore, knowledge of the variants present in the female population is essential to guide medical care and this could promote better clinical outcomes in women with CVD.