Dtsch Med Wochenschr 2017; 142(21): 1578-1584
DOI: 10.1055/s-0043-104467
Dossier
© Georg Thieme Verlag KG Stuttgart · New York

Koronare Herzerkrankung – Unterschiede in Symptomatik und Verlauf bei Männern und Frauen

Different Symptoms and Course of Coronary Heart Disease in Men and Women
Christopher Hohmann
,
Roman Pfister
,
Guido Michels
Further Information

Publication History

Publication Date:
18 October 2017 (online)

Abstract

According to the federal statistical office, cardiovascular disorders are still the leading cause of death in Germany. Chronic ischemic heart disease and acute myocardial infarction are the most important subgroups. In addition to evidence-based and personalized medicine, in recent years gender medicine has been established as an independent research area. Gender differences are evident in the majority of prevalent diseases, including cardiovascular disorders. The following article provides an insight into the diagnostically and therapeutically specific aspects of coronary heart disease in men and women.

Herz-Kreislauf-Erkrankungen – vor allem die chronische ischämische Herzerkrankung und der akute Myokardinfarkt – sind die häufigste Todesursache in Deutschland. Der Evidenz, dass Männer und Frauen bei vielen Krankheiten differente Symptome und Verläufe zeigen, geht seit einigen Jahren die Gendermedizin auf den Grund – so auch bei den Herz-Kreislauf-Erkrankungen. Der Beitrag bietet eine Übersicht spezifischer Aspekte zur Diagnostik und Therapie.

 
  • Literatur

  • 1 Löwel H. Gesundheitsberichterstattung des Bundes. Koronare Herzkrankheit und akuter Myokardinfarkt. Berlin: Robert-Koch-Institut; 2006 Heft 33.
  • 2 Wilmot KA, O’Flaherty M, Capewell S. et al. Coronary Heart Disease Mortality Declines in the United States From 1979 Through 2011: Evidence for Stagnation in Young Adults, Especially Women. Circulation 2015; 132: 997-1002
  • 3 Sader MA, Celermajer DS. Endothelial function, vascular reactivity and gender differences in the cardiovascular system. Cardiovasc Res 2002; 53 (03) 597-604
  • 4 Yahagi K, Davis HR, Arbustini E. et al. Sex differences in coronary artery disease: pathological observations. Atherosclerosis 2015; 239 (01) 260-267
  • 5 Pepine CJ, Anderson RD, Sharaf BL. et al. Coronary microvascular reactivity to adenosine predicts adverse outcome in women evaluated for suspected ischemia results from the National Heart, Lung and Blood Institute WISE (Women’s Ischemia Syndrome Evaluation) study. J Am Coll Cardiol 2010; 55 (25) 2825-2832
  • 6 Gulati M, Cooper-DeHoff RM, McClure C. et al. Adverse cardiovascular outcomes in women with nonobstructive coronary artery disease: a report from the Women’s Ischemia Syndrome Evaluation Study and the St James Women Take Heart Project. Arch Intern Med 2009; 169: 843-850
  • 7 Kim C, Hofer TP, Kerr EA. Review of evidence and explanations for suboptimal screening and treatment of dyslipidemia in women. A conceptual model. J Gen Intern Med 2003; 18 (10) 854-863
  • 8 Barrett-Connor EL, Cohn BA, Wingard DL. et al. Why is diabetes mellitus a stronger risk factor for fatal ischemic heart disease in women than in men? The Rancho Bernardo Study. JAMA 1991; 265: 627-631
  • 9 Ryden L, Grant PJ, Anker SD. et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 2013; 34: 3035-3087
  • 10 Giralt D, Domingues-Montanari S, Mendioroz M. et al. The gender gap in stroke: a meta-analysis. Acta Neurol Scand 2012; 125: 83-90
  • 11 Bushnell C, McCullough LD, Awad IA. et al. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45 (05) 1545-1588
  • 12 Davidson MH, Maki KC, Karp SK. et al. Management of hypercholesterolaemia in postmenopausal women. Drugs Aging 2002; 19 (03) 169-178
  • 13 Virani SS, Woodard LD, Ramsey DJ. et al. Gender disparities in evidence-based statin therapy in patients with cardiovascular disease. Am J Cardiol 2015; 115 (01) 21-26
  • 14 Huxley RR, Woodward M. Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies. Lancet 2011; 378: 1297-1305
  • 15 Wilson PW, D’Agostino RB, Sullivan L. et al. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 2002; 162: 1867-1872
  • 16 Zeller CB, Appenzeller S. Cardiovascular disease in systemic lupus erythematosus: the role of traditional and lupus related risk factors. Curr Cardiol Rev 2008; 4 (02) 116-122
  • 17 Mueck AO. Anwendungsempfehlungen zur Hormonsubstitution in Klimakterium und Postmenopause. Frauenarzt 2015; 56: 657-670
  • 18 Rozanski A, Blumenthal JA, Davidson KW. et al. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol 2005; 45 (05) 637-651
  • 19 Eaker ED. Psychosocial factors in the epidemiology of coronary heart disease in women. Psychiatr Clin N Am 1989; 12 (01) 167-173
  • 20 McSweeney JC, Cody M, O’Sullivan P. et al. Women’s early warning symptoms of acute myocardial infarction. Circulation 2003; 108 (21) 2619-2623
  • 21 Falcone C, Speccia G, Ronadanelli R. et al. Correlation between beta-endorphin plasma levels and anginal symptoms in patients with coronary heart disease. J Am Coll Cardiol 1988; 11: 719-723
  • 22 Mieres JH, Shaw LJ, Arai A. et al. Role of noninvasive testing in the clinical evaluation of women with suspected coronary artery disease: consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association. Circulation 2005; 111: 682-696
  • 23 Robinson JG, Wallace R, Limacher M. et al. Cardiovascular risk in women with non-specific chest pain. Am J Cardiol 2008; 102: 693-699
  • 24 Bougouin W, Dumas F, Marijon E. et al. Gender differences in early invasive strategy after cardiac arrest: Insights from the PROCAT registry. Resuscitation 2017; 114: 7-13
  • 25 Guelker JE, Bansemir L, Ott R. et al. Gender-based acute outcome in percutaneous coronary intervention of chronic total coronary occlusion. Neth Heart J 2017; 25 (05) 304-311
  • 26 Lehmkuhl E, Kendel F, Gelbrich G. et al. Gender-specific predictors of early mortality after coronary artery bypass graft surgery. Clin Res Cardiol 2012; 101: 745-751
  • 27 Kendel F, Dunkel A, Muller-Tasch T. et al. Gender differences in health-related quality of life after coronary bypass surgery: results from a 1-year follow-up in propensity matched men and women. Psychosom Med 2011; 73: 280-285
  • 28 Swaminathan RV, Feldman DN, Pashun RA. et al. Gender differences in in-hospital outcomes after coronary artery bypass grafting. Am J Cardiol 2016; 118 (03) 362-368
  • 29 Brown PP, Mack MJ, Simon AW. et al. Outcomes experience with off-pump coronary artery bypass surgery in women. Ann Thorac Surg 2002; 74 (06) 2113-2119
  • 30 Berger JS, Elliott L, Gallup D. et al. Sex differences in mortality following acute coronary syndromes. JAMA 2009; 302: 874-882