| DOES GENDER AFFECT SENSATION OF ISCHEMIA?
C. Noel Bairey Merz, M.D., Medical Director,
Preventative and Rehabilitative Cardiac Center, Cedars Sinai Medical Center, Los Angeles,
California
Review of chest pain
syndromes indicative of heart disease in women offers insight into possible gender-related
differences in pain perception. A critical paradox is observed with regard to women and
chest pain. Premenopausal women have relatively high rates of false positive chest pain
syndromes in the general population, where postmenopausal women have relatively high rates
of asymptomatic or silent heart disease. Specifically, women appear to over-recognize
chest pain symptoms in the premenopausal period, and under-recognize symptoms in the
postmenopausal period. A clear biological difference between premenopausal and
postmenopausal women is reproductive hormone levels, with estrogen and progesterone levels
falling and gonadotropin levels rising in the menopause. We hypothesize that women with
relatively high levels of estrogen within the menstrual cycle or associated with hormone
replacement therapy would have greater magnitudes of false positive chest pain syndromes
and more frequent symptoms, compared to similarly matched women with lower estrogen
levels. Data from the Women’s Ischemic Syndrome Evaluation (WISE) study, a
multicenter, NIH-NHLBI sponsored project, will be presented.
| Links for more information about the
author(s): |
| C. Noel Bairey Merz, M.D.,
Medical Director, Preventative and Rehabilitative Cardiac Center, Cedars Sinai Medical
Center |
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