Mild Heart Disease May Pose Equal Risks for Men and Women

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Study calculated chances of heart attack and cardiac death

WebMD News from HealthDay

By Steven Reinberg
HealthDay Reporter
TUESDAY, Dec. 3, 2013 (HealthDay News) -- Men and women with mild heart disease share the same risks, at least over the short term, a new study suggests.
Doctors have thought that women with mild heart disease do worse than men. This study, however, suggests that the rate of heart attacks and death among men and women with heart disease is similar.
Meanwhile, both men and women who don't have buildup of plaque in their coronary arteries have the same good chance of avoiding severe heart-related consequences, said lead researcher Dr. Jonathon Leipsic.
"If you have a normal CT scan, you are not likely to have a heart attack or die in the next 2.3 years -- whether you're a man or a woman," said Leipsic, director of medical imaging at St. Paul's Hospital in Vancouver, British Columbia. "That's an important new finding."
Leipsic said the ability to use a CT scan to diagnose plaque in the coronary arteries enabled researchers to determine that the outcomes are the same for men and women, regardless of what other tests show or what other risk factors patients have.
The results of the study were scheduled for presentation Tuesday at the annual meeting of the Radiological Society of North America, in Chicago.
When the coronary arteries -- the blood vessels that carry oxygen-rich blood to the heart -- start building fatty deposits called plaque, coronary artery disease occurs. Over time, plaque may damage or narrow the arteries, increasing the chances of a heart attack.
Dr. Gregg Fonarow, a spokesman for the American Heart Association, said coronary artery disease is associated with both fatal and nonfatal heart episodes, even when a person's arteries aren't narrowed. Fonarow was not involved with the new research.
The new study found similar increased risk for major adverse cardiac events in men and women, even after risk adjustment, said Fonarow, who is also a professor of cardiology at the University of California, Los Angeles.
Cardiovascular disease is a leading cause of death in both women and men.
"Irrespective of sex, controlling the seven major heart health risk factors -- smoking, high blood pressure, high cholesterol, diabetes, obesity, inactivity and poor diet -- can substantially reduce the risk of the development and progression of coronary artery disease," Fonarow said.
These new study findings also suggest that effective medical therapy, along with lifestyle modification, should be started in both men and women who have mild heart disease, he said.
For the study, Leipsic and his colleagues used data from a large international study registry. That registry included nearly 28,000 people from six countries who had images taken of their hearts.
The researchers identified more than 18,000 people without known heart disease whose scans were normal or showed mild disease, in which arteries were less than 50 percent blocked.
These patients, including about 8,800 women and 9,300 men, were then matched with more than 11,000 similar patients.
Based on scan findings and standard risk factors for heart attack and death, the researchers calculated that men and women with mild heart disease had the same risk for death or heart attack.
In addition, men and women who didn't have any heart disease had the same odds for good outcomes, Leipsic said.
Over more than two years of follow-up, only about 250 of the 18,000 patients had a heart attack or cardiac-related death, the researchers said.
Because the new study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.