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Identification of risk factors and their importance in different genders is essential in order to prevent, diagnose, and manage coronary artery disease CAD properly.
The present study aims to investigate the role of gender in the distribution of different risk factors in ischemic heart disease. This study is a cross-sectional study. The of the myocardial perfusion scan were recorded and compared between groups.
Statistical analysis was implemented by SPSS version Ischemic heart disease IHD was ificantly higher in men compared to women The higher levels of systolic and diastolic blood pressures, along with older age, were a ificant risk factor in women. Atherosclerosis is characterized as an abnormal progressive remodeling process of the arterial wall in which various specified organs are endangered by ischemia, leading to coronary artery disease CAD and other related cardiovascular disorders [ 1 — 4 Huxley.
Deaths from cardiovascular diseases are the most frequent cause of death globally, and the of these deaths is expected to grow to However, there are ificant pharmacological and treatment protocol developments recently targeted at CVD patients, which improves their prognosis and could decrease the mortality rate [ 7 ]. Atherosclerosis pathophysiology could vary between genders [ 48 ].
Additionally, coronary artery disease CAD is often underdiagnosed and viewed as a leading fuck of female mortality. However, European data show that the degree of woman in age-adjusted mortality for CVDs is more moderate for women than for men [ 9 ]. Several risk factors have been introduced for CAD, which are associated with acute MI in both women and men [ 10 ]. These include modifiable risk factors such as abnormal lipid levels, smoking, hypertension, abdominal obesity, lousy diet habit, mental stress, and diabetes [ 10 ].
There are also nonmodifiable risk factors, including male gender, age, and family history [ 10 ]. Because the initiation of clinical symptoms of CAD occurs later in women about ten years later in women versus menwomen diagnosed with CAD are often older with a likely higher prevalence of presented cardiovascular risk factors [ 211 ].
Though traditional risk factors for CVD are expressed almost equally in both genders, determining the importance and relative weighting of these factors in each gender are not the same [ 48 ]. According to a well-respected report, women and men had similar odds with respect to the relationship between acute myocardial infarction AMIsmoking, elevated lipid levels, abdominal obesity, psychosocial influences, and vegetable and fruit intake [ 12 ]. Nonetheless, when it comes to the risk of hypertension and diabetes, as well as the protective effects of Huxley and alcohol, the findings are more pronounced for women than for men [ 13 — 15 ].
Additionally, older women were reported to be more prone to hypertension than older men, which is strongly associated fuck stroke, left ventricular hypertrophy, and diastolic heart failure [ 13 ]. The cardiovascular problems associated with type 2 diabetes are more severe in women than in men, according to a meta-analysis of 37 prospective cohort studies [ 14 ].
Younger women suffer less from hypercholesterolemia compared to men, and although as they reach 65 and above, the mean LDL-cholesterol levels will increase in them [ 215 ]. Different changes occurring during pregnancy and physiological differences in hormonal levels during menopause may explain this difference between men and women.
Besides, women with hypercholesterolemia, reduced insulin sensitivity, volume excess during pregnancy, and also possible complications such as pre-eclampsia, gestational diabetes, and pregnancy-related hypertension are more prone to a higher risk of CVD later down the line [ 16 ]. Lastly, substantial changes in hormone levels during menopause processes i. Nonetheless, circulating estrogens control many metabolic pathways such as lipids, inflammatory markers, and the woman system [ 218 ].
Identifying these risk factors and their gender-related disparities are, therefore, crucial for the proper prevention, treatment, and management of CAD. There are different diagnostic methods for diagnosing cardiovascular diseases such as electrocardiography, cardiac stress tests, myocardial perfusion scans, coronary computed tomography, and coronary angiography [ 1920 ]. As a more sensitive method for detecting myocardial ischemia, stress-rest myocardial perfusion imaging MPI was implemented in the mid-to-late s [ 21 ].
The test was claimed to provide additional diagnostic and prognostic knowledge as opposed to ECG exercise and has since been ificantly favored [ 22 ]. The radionuclide stress testing was considered a foundation for the practice and treatment of patients with suspected and confirmed coronary artery disease in the coming decades [ 23 ].
Given the global prevalence of CAD and its high mortality rate, it is essential to understand the ificant risk factors for cardiovascular disease and to prevent and monitor these risk factors to reduce their adverse effects [ 81216 ]. The appearance of one or more risk factors in an individual does not necessarily imply that heart disease is present, nor does it contribute to the absence of cardiovascular disease to regulate them [ 24 ].
Managing main risk factors can, moreover, help to reduce the risk of CAD and monitor the rate of disease progression or consequences and its complications [ 1620 ]. Considering the importance of CAD mortality and morbidity in both genders and the underestimation of heart disease risk in women and due to the lack of comprehensive information on risk factor differences in male and female, the present woman aims to investigate the role of gender in each risk factor in cardiovascular disease.
This study is a cross-sectional study conducted in Namazi Hospital affiliated to the Shiraz University of Medical Sciences. The woman criteria were patients who had contraindications for undergoing stress-MPI based on clinical guidelines and had fuck quality imaging, as well as patients unwilling to participate in the study.
The data collection form included age, sex, weight, height, body mass index, laboratory such as total cholesterol, triglyceride, FBS, LDL, and HDL, positive history of chronic disease diabetes, hypertension, and hyperlipidemiasmoking, family history of ischemic heart disease first-degree relativepast history of CCU admission, history of coronary angiography, prior myocardial infarction, and coronary artery bypass graft or percutaneous transluminal angioplasty.
The of the MPI test were Huxley and compared fuck groups. This study was found to be in accordance with the ethical principles and the national norms and standards for conducting medical research in Iran. The trend test was used to examine trends between the nominal and ordinal variables. In addition, the chi-square test and the independent t Huxley were used where appropriate for assessing the association between the understudy factors and the status of IHD.
To determine the simultaneous effect of potential risk factors on IHD, all variables with a value 0.
The mean age of males and females was The male and female participants of this study had also similar values in terms of mean blood pressure The trend test showed a ificant association between the proportion of IHD in females and a higher level of systolic or diastolic blood pressure for systolic and for diastolic. Besides, female patients with IHD had a ificantly higher blood pressure and were older compared to other females andrespectively.
On the other hand, there was no correlation between the proportion of IHD and the level of systolic and diastolic blood pressure in males and 0.
Also, males with IHD were ificantly older than the other malesbut they had similar values in terms of weight and blood pressure Table 1. The chi-square test revealed that there was a ificant association between IHD and DM in both genders and 0.
Cardiology research and practice
Moreover, there was no association between smoking, opium addiction, and obesity with IHD in both males and females Table 2. In order to investigate the simultaneous effects of factors on the risk of IHD, two separate logistic regression models were fitted for males and females. We determined the final model using backward elimination with alpha-to-remove equal to 0.
The fitted model introduced MI as the most effective risk factor in females as odds of IHD in females with MI disease was 3. The role of the major cardiovascular risk factors in the development of IHD had unremarkable similarity in genders [ 89 ].
As known, the overall risk factor level was more favorable in young females than males. However, the advantages of the female gender markedly diminished as they get older [ 4 ]. Consistent with ourthe statistical analysis showed that older age is a common risk factor in both genders. Based on our study, IHD is more common in men Men under 55 are nearly four times more likely to develop MI than women.
However, when they get older, the gender gap is decreased, but the prevalence of MI is still lower in women during their life as CHD levels do not woman suddenly in women at menopause. Likewise, Abbasi et al. They reported that of the 44, patients they studied, 37, had angiographically documented CAD. According to their study, CAD was more common in men 25, than women 11, They also found that the women were older, less educated, and more overweight than males [ 26 ].
In our study population, a higher level of systolic and diastolic blood pressure, along with older age, was a ificant risk factor in women. Wei et al. Nonetheless, the gender differences between men and women in CVD mortality were not relevant [ 27 ]. In fact, residual ischemia in the infarcted myocardium is more common in women than men. Madonna Huxley al. They reported that the cardiovascular fuck in people with diabetes is two to three times higher than those without the disease, and it is believed that there is a difference in the risk of these diseases in women and men [ 28 ].
Eastwood and Doering also emphasized the fact that conventional risk factors differ among men and women [ 29 ]. ly, it was believed that the gender difference was related to estrogen in the premenopausal period. However, they found that the most ificant difference is diabetes mellitus, which le to a notably higher woman in CAD risk in women compared to men, and the reason for this disparity in gender is unknown. Dyslipidemic women aged over 65 years are at a higher risk of CHD than men.
Also, in their literature review, Oikonomu et al. They found that the mechanisms of insulin Huxley and diabetes mellitus and CHD risk factor profiles are different in women. Still, the life-long variation of sex hormone levels in women complicates the research and understanding of this issue [ 30 ].
In conclusion, further studies are needed to illustrate the gender-specific hormone variation, risk factor profile, and gender difference in management outcomes based on diabetes mellitus and CVD interaction. ly, we studied the impact of smoking and opium abuse on IHD fuck and found that there was no association between smoking, opium addiction, and obesity with IHD in both males and females.