Coronary Artery Disease -
What’s
Different for Women?
Presentation
- Women present at a later age.
- In women, typical
angina is less predictive of coronary artery disease.
- Probability
is 50 to 60 percent in women (versus 80 to 99 percent in men).
- Women
may present with shoulder or jaw pain, dyspnea or nausea.
Risk Factors
- Diabetes has a stronger influence in women.
- High
HDL (high‐density lipoprotein) cholesterol levels, which lower the
risk of coronary artery disease, are more common in women.
- The roles of total cholesterol, LDL(low‐density lipoprotein) cholesterol
and lipoprotein in women are unclear.
- The risk of coronary artery
disease increases after menopause. Prognosis
- Women are more likely
to die of a first myocardial infarction.
- Women experience more long‐term
disability.
- Women have more co‐morbidity (because they are usually
older on presentation).
Primary Prevention
- There is insufficient evidence
for the benefits of cholesterol‐lowering drugs in women.
- There
is insufficient evidence for the benefit of estrogen replacement therapy.
Secondary Prevention
- Women are less likely to undergo angioplasty
or bypass surgery.
- Fewer
women receive cardiac rehabilitation.
- Fewer women receive therapy
with aspirin, beta blockers or angiotensin converting enzyme inhibitors.
Coronary Artery Disease (CAD)
- Kills more than 500,000 Americans annually.
- 85% can be halted or prevented if it is discovered early enough.
- MDCT provides a simple and reliable test that identifies those with early
CAD so treatment can be started before the disease worsens.
Evolution of Plaque in Coronary Artery Disease

