UNMODIFIED RISK FACTORS OF CORONARY ARTERY DISEASE: SEX
Coronary artery disease is the leading cause of death for both sexes. It is hard to separate the role of your sex in the development of coronary artery disease from other factors such as smoking, blood pressure, and cholesterol levels. Men and women who smoke or who have high blood pressure or hi blood cholesterol levels have higher risks of heart disease than others who control these factors.When you consider only the sex difference, men are more likely to have coronary artery disease than women-until women reach the age of menopause. Then the difference in risk between men and women shrinks.This difference certainly does not mean that women are “immune” from heart disease. In fact, 47 percent of American victims of fatal heart attack are women. In women, coronary artery disease develops, on the average, about 10 years later than in men.The female hormone estrogen may be one protector against heart disease. After its decline at menopause, women’s risks increase. The use of estrogen after menopause seems to reduce a woman’s risk of heart disease. However, it may increase her risk of cancer in the lining of the uterus (endometrial cancer) and possibly of breast cancer. There is evidence that smoking may reduce estrogen levels in women and may hasten menopause—results that add to its list of bad effects on the heart.Until recently, much of the research relating to coronary artery disease focused mainly on men (see page 336). New studies are under way to determine whether the findings are applicable to women as well.*224\252\8*
