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	James L. Holly, M.D.

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Your Life Your Health - Women and Heart Disease: It can be prevented!

James L. Holly,M.D.

March 01, 2005

Cardiology Review March 2005, Vol 22 No 3

Yes, we can prevent coronary heart disease in women --- Commentary

Diabetes might have a greater impact on risk in women, such that women with diabetes have similar rates of cardiac events.
Men and women have similar risk factors:
1. Dyslipidemia
2. Hypertension
3. Diabetes
4. Cigarette smoking
Treatment of hypertension markedly reduce cardiac events.
Differences in lipoprotein profiles have been suggested as the reason for the lower coronary risk in young women.
HDL levels are higher in women and this increase continues through menopause.
The reasons for the higher HDL:
1. Estrogen reduces the expression of hepatic lipase, an enzyme involved in HDL catabolism.
2. Estrogen therapy also induces greater hepatic production of apoA1, the major apoprotein in HDL.
LDL rises in men as they age beginning as early as the fourth decade:
1. possibly due to weight gain beginning in he late 20s.
2. possibly due to sedentary life style.
Women who also experience weight gain during this period do not have LDL increases until after menopause.
All women with coronary heart disease or diabetes need cholesterol reduction unless hey have already have very low LDL.
The Framingham Risk score helps determine women who need treatment.

Other Articles in the Cardiovascular Disease in Women Series

	Women and Heart Disease: Congestive Heart Failure Women and Heart Disease: Primary Prevention Women and Heart Disease: Testing Guidelines Women and Heart Disease: Hormone Usage Women and Heart Disease: Hormone Replacement Therapy

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