Understanding Heart Attacks
Heart attacks can be frightening. They occur when the blood supply to the heart is blocked, often by a build-up of fat, cholesterol, and other substances, which form a plaque in the arteries.
This condition is known as atherosclerosis. Although both men and women can have heart attacks, a recent study shows that postmenopausal women might be at a higher risk than men of similar age.
The Study: Postmenopausal Women and Heart Attacks
The study was presented at the EACVI 2023, a major scientific congress held by the European Society of Cardiology. It was also published in the European Heart Journal—Cardiovascular Imaging.
The researchers looked at nearly 25,000 adults, using advanced imaging techniques to examine their arteries. They then followed these participants to track occurrences of heart attacks and death.
Dr. Sophie van Rosendael of Leiden University Medical Centre in the Netherlands led the study.
She explained that atherosclerotic plaque, the substance that clogs arteries, seems to be riskier for postmenopausal women than for men of the same age.
The team’s findings may have significant implications for treatment.
For instance, postmenopausal women might need higher doses of statins or additional lipid-lowering drugs. However, more studies are required to confirm these findings.
Atherosclerosis is the narrowing of arteries due to the accumulation of plaque, which is made up of fat and cholesterol.
Women generally develop atherosclerosis later in life than men and have heart attacks at an older age. This delay is partly due to the protective effect of estrogen.
The study aimed to determine whether the prognostic importance of atherosclerotic plaques is the same for women and men at different ages.
This information could be critical in choosing treatments to prevent heart attacks.
Understanding the Study Methodology
The study involved 24,950 patients who underwent coronary computed tomography angiography (CCTA), a test that provides 3D images of the heart’s arteries.
The researchers used the Leiden CCTA score to rate the total atherosclerotic burden. This scoring system considers plaque presence, composition, location, and the severity of arterial narrowing.
Patients were divided into three categories based on their risk of heart attack: low atherosclerotic burden, medium, and high.
The primary goal was to compare the Leiden CCTA scores between women and men of similar ages.
What Were the Findings?
The study found that women experience the onset of coronary atherosclerosis about 12 years later than men.
Interestingly, women were more likely to have non-obstructive disease, which means the plaque doesn’t entirely block the artery but is still risky.
The risk of major adverse cardiovascular events (MACE), including death and heart attack, was equally predicted by the burden of atherosclerosis in premenopausal women and men under 55 years old.
But for postmenopausal women aged 55 years and older, the risk of MACE was higher than men for a given score.
What Does This Mean for Postmenopausal Women?
Dr. van Rosendael explains that the higher risk for postmenopausal women could be due to the smaller inner diameter of their coronary arteries.
Therefore, the same amount of plaque could have a larger impact on blood flow.
These findings link the known acceleration of atherosclerosis development after menopause with a significant increase in relative risk for women compared to men.
This study highlights the need for a more personalized approach to the prevention and treatment of heart disease, particularly for postmenopausal women.
If you care about heart health, please read studies about an important cause of heart disease, and how to remove plaques that cause heart attacks.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
The study was published in Eur Heart J Cardiovasc Imaging.
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