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Arterial vascular disease underdiagnosed, undertreated in older US women
Date:11/21/2007

s vascular illness. Thats all changed because the average American woman now lives well into her 80s.

Other factors have conspired to keep women with arterial vascular disease off of doctors radar. Women typically outlive their male partners and are then left aloneeither isolated at home or placed in nursing homes. They often have fewer financial resources and caregiver support to draw on, as well. This means they often dont get the care they deserve, Dr. Vouyouka says.

In their paper, the two researchers pored over the existing literature on women and arterial vascular disease, breaking the findings down into the three main disease subtypes. Some of their findings:

For carotid stenosis:

  • Womens carotid and vertebral arteries are markedly smaller than those of men, so it takes less plaque buildup to cause severe restrictions in blood flow. However carotid plaque is more stable in women and therefore the risk of stroke becomes significant at higher degree of stenosis as compared to men.

  • Plaque composition within the artery appears to differ between the sexes, and certain risk factorssuch as high blood levels of C-reactive protein, use of hormone replacement therapy (HRT) and osteoporosismay be unique to women.

  • Women were under-represented in all major trials for carotid endarterectomy (surgery to correct the blockage of the neck arteries-CEA) and therefore the outcome of the procedure on women is not well analyzed. However it appears that carotid endarterectomy (CEA) probably carries a higher rate of complications for women, including stroke and therefore the procedure should be done for higher degree of stenosis in women, compared to men.

For aortic aneurysmal disease (AAA):

  • Because of hormonal and other factors, this condition develops much later in life in women, compared to men.

  • The U.S. Preventive Service Task Force currently recommends against screening for A
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Contact: Belinda Mager
bem9048@nyp.org
212-305-5587
New York- Presbyterian Hospital/Columbia University Medical Center
Source:Eurekalert

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