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  • Print publication year: 1997
  • Online publication date: February 2010

8 - Coronary artery disease and women: Estrogens and psychosocial and lifestyle risk factors

Summary

Cardiovascular disease is the leading cause of death in women as it is in men. The lower incidence of coronary artery disease (CAD) in young and middle-aged women compared to men has led to the exclusion of women from nearly all randomized controlled studies on risk factors, treatment, and outcome from coronary heart disease (CHD). Among women aged 55-65, mortality rates from CHD triple compared to those aged 45-55, and after the seventh decade, the rate of CHD for women equals that of men. Since women have been included in trials, coronary risk factors similar to those for men have emerged, even though the onset of clinical CHD is delayed by 10-20 years in women compared to men. The lower CHD risk in premenopausal women has been attributed to the beneficial effects of estrogen on lipoprotein profiles. Furthermore, levels of reproductive hormones affect the magnitude of stress responses.