Which of the following statements regarding coronary heart disease (CHD) in women when compared with men is TRUE?
ExplanationCoronary heart disease (CHD) is the most common cause of death in men and women, but important sex differences exist in the presentation and treatment of CHD. At the time of presentation of CHD, women are about 10–15 years older than men with CHD. In addition, women have a greater number of medical comorbidities at the time of diagnosis, including hypertension, heart failure, and diabetes mellitus. Angina is the most common presenting symptom of CHD in women and may have atypical features, including nausea, indigestion, and upper back pain. Women who present with a myocardial infarction (MI) more often present with cardiogenic shock or cardiac arrest, but men have a greater risk of ventricular tachycardia on presentation with MI. In the past, women had a greater risk of death from MI when presenting at younger ages, but this gap has decreased in recent years. However, women are still referred less often by physicians for diagnostic and therapeutic cardiovascular procedures, and there are more false-positive and false-negative diagnostic test results in women. Women are also less likely to receive angioplasty, thrombolysis, coronary artery bypass grafting, aspirin, and beta-blockers. Despite this, the 5- and 10-year survival rates after coronary artery bypass grafting are the same for men and women.
