Polk Donna M, Naqvi Tasneem Z
Cedars-Sinai Medical Center, Division of Cardiology, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA.
Curr Cardiol Rep. 2005 May;7(3):166-72. doi: 10.1007/s11886-005-0072-9.
Cardiovascular disease (CVD) is the leading cause of mortality in women. Pathophysiology, risk factors, clinical presentation, and outcomes of coronary artery disease (CAD) differ in women, and a better understanding of the sex differences in these factors will potentially lead to a slowing of this epidemic in women. Often forgotten, women have higher complication rates post revascularization and higher in-hospital mortality post myocardial infarction compared with men despite a smaller burden of disease in women. Though overall women share the same risk factors as men in the development of CAD, certain risk factors appear to be particularly ominous, such as the presence of diabetes mellitus, low values of high-density lipoprotein cholesterol, high triglycerides, and psychologic depression. Disease detection in advanced CAD is more accurate with stress echocardiography (ECG) and perfusion single-photon emission computed tomography imaging in women than with stress ECG. Subclincial atherosclerotic disease detection with carotid artery intima media thickness assessment provides an opportunity to target preventive measures in women. This article focuses on some of the sex-specific differences.
心血管疾病（CVD）是女性死亡的主要原因。冠心病（CAD）的病理生理学、危险因素、临床表现及预后在女性中有所不同，更好地了解这些因素中的性别差异可能会减缓女性中的这一流行趋势。常常被忽视的是，尽管女性的疾病负担较轻，但与男性相比，女性血管重建术后并发症发生率更高，心肌梗死后住院死亡率也更高。虽然总体而言，女性在CAD发生发展中与男性有相同的危险因素，但某些危险因素似乎特别凶险，如糖尿病的存在、高密度脂蛋白胆固醇水平低、甘油三酯高以及心理抑郁。对于晚期CAD，女性采用负荷超声心动图（ECG）和灌注单光子发射计算机断层扫描成像检测疾病比负荷ECG更准确。通过颈动脉内膜中层厚度评估来检测亚临床动脉粥样硬化疾病为针对女性采取预防措施提供了机会。本文重点关注一些性别特异性差异。
