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When Arteries Narrow, Chest Pain Can Come Earlier for Women Than Men

TUESDAY, March 24, 2020 (HealthDay News) -- Women with coronary artery disease have less narrowing in their blood vessels but more chest pain than men with the condition, a new study finds.

In coronary artery disease, plaque build-up in arteries results in reduced blood flow (ischemia) to the heart.

The study included more than 1,100 women and more than 4,000 men whose results on cardiac stress tests indicated they had moderate to severe ischemia.

Women had a 38% higher chance of having more chest pain than men, the study found. And that held true even after researchers accounted for such factors as age, race, stress test findings, medication use, smoking, diabetes, high blood pressure, prior heart attack, kidney function and overall heart function.

The findings are to be presented at an online meeting of the American College of Cardiology/World Congress of Cardiology March 28 to 30. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

"Women are having more chest pain even though they have less plaque on imaging, and yet they have very abnormal stress test results," said lead author Dr. Harmony Reynolds, director of the Center for Women's Cardiovascular Disease at NYU Langone Health in New York City.

"These findings suggest that just because there may not be as much plaque, many women may have chest pain that limits their daily activities, and we have medicines that can improve chest pain from heart disease," she said in an ACA news release.

More severe chest pain is often associated with a higher risk of heart attack or death.

More research is needed to understand the findings, Reynolds said.

"The heart has nerves that can sense when there isn't enough blood flow, but we can't always tell if those nerves have been activated by a large amount of heart muscle or a smaller amount," she said.

"Just like a small cut on your finger can really sting and hurt and yet it may hardly look like anything. So when it comes to the burden of chest pain in these women, is it because the activation of nerve endings in a relatively smaller amount of heart muscle will raise the red flag in a woman's brain differently, or is it because there are other factors going on in women, like small vessel disease, that we aren't assessing with the tests that we are using?"

More information

The American Academy of Family Physicians has more on coronary artery disease.

SOURCE: American College of Cardiology, news release, March 18, 2020

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