Cardiovascular Disease in Women

다국어 초록 (Multilingual Abstract)

More women have died from cardiovascular disease since middle 1980’s than men due to the women’s older ageand multiple comorbid conditions. Additionally, women with acute coronary syndrome have worse outcomes, includingsudden cardiac death and death before arriving to the hospital, due to the women’s atypical symptoms andthe delayed diagnosis and treatment. There are many reports on the gender-specific differences in the pathophysiologyof ischemic heart disease. In addition to the previous reports, the WISE study was started for improvingboth our understanding and the clinical outcomes of ischemic heart disease of women. These studies have suggestedthe structural and functional differences in the female vasculature, new paradigms for the diagnosis and treatmentof the ischemic heart disease of women, the various roles of estrogen and the new therapeutic targets forpreventing ischemic heart disease (IHD) or improving cardiovascular outcomes. On-going and future studies shouldfocus on further understanding of the pathophysiology, the clinical usefulness of the new diagnostic markers thatmay related to the IHD of women, and the development of non-invasive, easily reproducible diagnostic tools for earlydetection of IHD and for predicting the adverse outcomes. (Korean Circulation J 2006;36:771-779)

참고문헌 (Reference)

1 "ischemic heart disease, revascularization, andthe gender gap: what are we missing?" 47 : 63-65, 2006

2 "correlations among history of angina ST-segment response andprevalence of coronary-artery disease in the Coronary ArterySurgery Study" 230-5,

3 "Women’s early warning symptoms of acute myocardialinfarction" 108 : 2619-2623, 2003

4 "Women and cardiovascular heart disease:clinical implications from the Women’s Ischemia Syndrome Evaluation(WISE) Study: are we smarter?" 47 : 59-62, 2006

5 "Whyis diabetes mellitus a stronger risk factor for fatal ischemic heartdisease in women than in men" 627-31, jama1991

6 "Value of exercise treadmill testing in women" 32 : 1657-1664, 1998

7 "Upregulation ofmyocardial estrogen receptors in human aortic stenosis" 110 : 3270-3275, 2004

8 "Trends in the incidenceand survival of patients with hospitalized myocardial infarction 1979 to 1994" 136 : 341-348, 2002

9 "The value of estimated functionalcapacity in estimating outcome:the NHLBI-sponsored Women’sIschemia Syndrome Evaluation(WISE)study" 47 : 36-43, 2006

10 "The pathophysiology of cigarette smokingand cardiovascular disease:an update" 43 : 1731-1737, 2004

11 "The association of hypertensionand dyslipidemia in postmenopausal women" 29 : 1195-1200, 1999

12 "The Women’s IschemiaSyndrome Evaluation (WISE) study: protocol design, methodologyand feasibility report" 33 : 1453-1461, 1999

13 "Some thoughts onthe vasculopathy of women with ischemic heart disease" 47 : 30-35, 2006

14 "Sex-based differences in early mortality after myocardial infarction" 341 : 217-225, 1999

15 "Sex-associated differencesin left ventricular function in aortic stenosis of the elderly" 86 : 1099-1107, 1992

16 "Sex differences inchest pain in patients with documented coronary artery diseaseand exercise induced ischemia:results from the PIMI study" 142 : 864-871, 2001

17 "Risk factors and angiographic coronary artery disease:areport from the Coronary Artery Surgery Study(CASS)" 62 : 254-61, 1980

18 "Retinal arteriolar narrowingand risk of coronary heart disease in men and women" 287 : 1153-1159, 2002

19 "Relationship of physicalfitness vs body mass index with coronary artery disease andcardiovascular events in women" 292 : 1179-1187, 2004

20 "Randomized trial of estrogenplud progestin for secondary prevention of coronary heart diseasein postmenopausal women" 280 : 605-613, 1998

21 "Prognosticrole of reversible endothelial dysfunction in hypertensive postmenopausalwomen et al：Cardiovascular Disease in Women" Cardiovascular Disease in Women 40 : 505-510, 2002

22 "Prognosis in women withmyocardial ischemia in the absence of obstructive coronary disease:results from the NIH-NHLBI-sponsored Women’s IschemiaSyndrome Evaluation(WISE)" 109 : 2993-2999, 2004

23 "Prevalence andtrends in overweight among U.S. children and adolescents, 1999-2000." 288 : 1728-1732, 2002

24 "Plasma triglyceride level is a riskfactor for cardiovascular disease independent of high-density lipoproteinlevel:a meta-analysis of population-based prospectivestudies" 3 : 213-219, 1996

25 "Obesity as a cardiovascular risk factor" 115 : 37-41, 2003

26 "Myocyte death in the failinghuman heart is gender dependent" 85 : 856-866, 1999

27 "Myocardial Akt activationand gender:increased nuclear activity in females versusmales" 88 : 1020-1027, 2001

28 "Modulation of the ligand-independent activation of the human estrogen receptor byhormone and antihormone" 90 : 6120-6124, 1993

29 "Menopause: problemsand interventions in the United States" Kluwer AcademicPublishers 9-14, 1997

30 "Korea National Statistical Office statistics 2005 Update" 2005

31 "Korea National Statistical Office statistics 2003 Update" 2003

32 "Isearly invasive treatment of unstable coronary artery diseaseequally effective for both women and men?" 38 : 41-48, 2001

33 "Insights from theNHLBI-Sponsored Women’s Ischemia Syndrome Evaluation (WISE)Study: part II. gender differences in presentation, diagnosis, andoutcome with regard to gender-based pathophysiology of atherosclerosisand macrovascular and microvascular coronary disease" 47 : 21-29, 2006

34 "Insights From theNHLBI-Sponsored Women’s Ischemia Syndrome Evaluation gender differences in traditional and novel risk factors,symptom evaluation, and gender-optimized diagnostic strategies" 47 : 4-20, 2006

35 "Hypoestrogenemiaof hypothalamic origin and coronary artery disease in premenopausalwomen:a report from the NHLBI-sponsored WISEstudy" 41 : 413-419, 2003

36 "Hypertension,menopause, and coronary artery disease risk in the Women’sIschemia Syndrome Evaluation (WISE) Study" 50-58, 2006

37 "Hypertension in women:current understandingof gender differences" 73 : 157-165, 1998

38 "Heart failure and its treatment inwomen:role of hypertension,diabetes,and estrogen" 30 : 356-367, 2005

39 "Heart disease and strokestatistics-2006 update" 113 : 85-151, 2006

40 "Gender-relatedchanges in the practice and outcomes of percutaneous coronaryinterventions in northern New England 1994 to 1999" 40 : 2092-2101, 2002

41 "Explaining the sex differencein coronary heart disease mortality among patients withtype 2 diabetes mellitus:a meta-analysis" 162 : 1737-1745, 2002

42 "Effects of race with or without gender a study using the Society of ThoracicSurgeons national database" 71 : 512-520, 2001

43 "Effect of menopause onplaque morphologic characteristics in coronary atherosclerosis" 141 : 58-62, 2001

44 "Effect of estrogen on globalmyocardial ischemia-reperfusion injury in female rats" 279 : 2766-2775, 2000

45 "Double-blind randomized placebo-controlled study of transdermalestrogen replacement therapy on hypertensive postmenopausalwomen" 12 : 1000-1008, 1999

46 "Differences in medicalcare and disease outcomes among black and white women withheart disease" 108 : 1089-1094, 2003

47 "Definition and epidemiology of hypertensive cardiovasculardisease in women:the size of problem" 20 : 3-5, 2002

48 "Coronary revascularization in women in 2003:sexrevisited" 107 : 375-377, 2003

49 "Coronary artery bypass graft surgeryin women" 18 : 344-352, 2004

50 "Comparisonof C-reactive protein and low-density lipoprotein cholesterol levelsin the prediction of first cardiovascular events" 347 : 1557-1565, 2002

51 "Comparative diagnostic accuracy of Tl-201 and Tc-99msestamibi SPECT imaging(perfusion and ECG gated SPECT)in detecting coronary artery disease in women" 29 : 69-77, 1997

52 "Clinical characteristicsand thrombolysis in myocardial infarction frame counts in womenwith transient left ventricular apical ballooning syndrome" 94 : 343-346, 2004

53 "Cardiovascular health and disease in women"

54 "Benefit of an earlyinvasive management strategy in women with acute coronary syndromes" 288 : 3124-3129, 2002

55 "Assessing hypertension management in the community and control of hypertension inthe MONICA Project," 15 : 27-36, 2001

56 "Aspirin for the primary prevention of cardiovascularevents in women and men:a sex-specific meta-analysis of ramdomizedcontrolled trials" 295 : 306-313, 2006

57 "American Society of NuclearCardiology consensus statement" 10 : 95-101, 2003

58 "Age-related difference in longtermprognosis of acute myocardial infarction in women" 30 : 1245-1256, 2000

59 "Activation of estrogenreceptor beta is a prerequisite for estrogen-dependent upregulationof nitric oxide synthases in neonatal rat cardiac myocytes" 502 : 103-108, 2001

60 "Abnormal subendocardialperfusion in cardiac syndrome X detected by cardiovascularmagnetic resonance imaging" 346 : 1948-1953, 2002

61 "Abnormal myocardialphosphorus-31 nuclear magnetic resonance spectroscopyin women with chest pain but normal coronary angiograms" 342 : 829-835, 2000

62 "Abnormal coronaryvasomotion as a prognostic indicator of cardiovascular events inwomen: results from the National Heart, Lung, and Blood InstituteInstitute Sponsored Women’s Ischemia Syndrome Evaluation(WISE)" 109 : 722-725, 2004

63 "A randomizes trials of lowdoseaspirin in the primary prevention of cardiovascular diseasein women" 352 : 1293-1304, 2005

64 "A decade ofchange: risk profile and outcomes for isolated coronary arterybypass grafting procedures, 1990-1999. Society of Thoracic Surgeons" 73 : 480-489, 2002