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Geriatric Insights on Elderly Women and Heart Disease

  • Women and Heart Disease (E. Jackson, Section Editor)
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The prevalence of heart diseases is growing in recent years and will further rise because of the increased longevity of elderly population, mainly reported for the female gender.

Recent Findings

Several studies have demonstrated the presence of a large sex-specific variability on physiopathology, presentation, and overall prognosis of cardiovascular diseases (CVD). Women, in particular, tend to present heart diseases generally later than men, have a higher number of comorbidities, and report worse outcomes. Moreover, atypical symptomatology of heart diseases in older women constitutes a potential source of delay in the identification of such pathologies, influencing the management of CVDs that is still characterized by a lesser access to invasive procedures for the female gender compared with the male one. The lack of knowledge in the field of sex-specific disparities in CVDs is probably due to the underrepresentation of women in the first large cardiovascular trials, with the processing of guidelines for the prevention, identification, and treatment of CVDs that do not consider gender variability.

Summary

Although growing attention has been recently dedicated to this topic, further investigations are needed to fully analyze heart diseases in elderly women with the aim of developing new and targeted recommendations for clinical practice.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. • Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–245. doi:10.1161/CIR.0b013e31828124ad. This report provides documentary evidence of the diffusion of cardiovascular diseases in the current society and of the impact of such pathologies for health care.

    Article  PubMed  Google Scholar 

  2. National Institutes of Health-National Heart, Lung, and Blood Institute. Incidence and prevalence: 2006 chart book on cardiovascular and lung diseases. United States: Bethesda; 2006.

    Google Scholar 

  3. Worrall-Carter L, Ski C, Scruth E, Campbell M, Page K. Systematic review of cardiovascular disease in women: assessing the risk. Nurs Health Sci. 2011;13:529–35. doi:10.1111/j.1442-2018.2011.00645.x.

    Article  PubMed  Google Scholar 

  4. Matthews KA, Crawford SL, Chae CU, Everson-Rose SA, Sowers MF, Sternfeld B, et al. Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition? J Am Coll Cardiol. 2009;54:2366–73. doi:10.1016/j.jacc.2009.10.009.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Banks E, Canfell K. Invited commentary: hormone therapy risks and benefits—the women’s health initiative findings and the postmenopausal estrogen timing hypothesis. Am J Epidemiol. 2009;170:24–8. doi:10.1093/aje/kwp113.

    Article  PubMed  Google Scholar 

  6. Clarkson TB, Meléndez GC, Appt SE. Timing hypothesis for postmenopausal hormone therapy: its origin, current status, and future. Menopause. 2013;20:342–53. doi:10.1097/GME.0b013e3182843aad.

    Article  PubMed  Google Scholar 

  7. Goldberg RJ, Gorak EJ, Yarzebski J, Hosmer DW, Dalen P, Gore JM, et al. A communitywide perspective of sex differences and temporal trends in the incidence and survival rates after acute myocardial infarction and out-of-hospital deaths caused by coronary heart disease. Circulation. 1993;87(6):1947–52.

    Article  CAS  PubMed  Google Scholar 

  8. Claassen M, Sybrandy KC, Appelman YE, Asselbergs FW. Gender gap in acute coronary heart disease: myth or reality? World J Cardiol. 2012;4:36–47. doi:10.4330/wjc.v4.i2.36.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Worrall-Carter L, McEvedy S, Wilson A, Rahman MA. Gender differences in presentation, coronary intervention, and outcomes of 28,985 acute coronary syndrome patients in Victoria, Australia. Womens Health Issues. 2015;26:14–20. doi:10.1016/j.whi.2015.09.002.

    Article  Google Scholar 

  10. • Sharma K, Gulati M. Coronary artery disease in women: a 2013 update. Glob Heart. 2013;8:105–12. doi:10.1016/j.gheart.2013.02.001. This review summarizes the sex-specific variability regarding risk factors, presentation and management of coronary artery disease in the female gender.

    Article  PubMed  Google Scholar 

  11. Hopper I, Kotecha D, Chin KL, Mentz RJ, von Lueder TG. Comorbidities in heart failure: are there gender differences? Curr Heart Fail Rep. 2016;13:1–12. doi:10.1007/s11897-016-0280-1.

    Article  PubMed  Google Scholar 

  12. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129:e28–292. doi:10.1161/01.cir.0000441139.02102.80. This report provides documentary evidence of the diffusion of cardiovascular diseases in the current society and of the impact of such pathologies for health care.

    Article  PubMed  Google Scholar 

  13. • Conde-Martel A, Arkuch ME, Formiga F, Manzano-Espinosa L, Aramburu-Bodas O, González-Franco Á, et al. Gender related differences in clinical profile and outcome of patients with heart failure. Results of the RICA Registry. Rev Clin Esp. 2015;215:363–70. doi:10.1016/j.rce.2015.02.010. This study investigates the gender-related differences in the clinical pattern, risk factors, physiopathology, management, and outcomes of patients with heart failure.

    Article  CAS  PubMed  Google Scholar 

  14. Klein L, Grau-Sepulveda MV, Bonow RO, Hernandez AF, Williams MV, Bhatt DL, et al. Quality of care and outcomes in women hospitalized for heart failure. Circ Heart Fail. 2011;4:589–98. doi:10.1161/circheartfailure.110.960484.

    Article  PubMed  Google Scholar 

  15. Shah AN, Mentz RJ, Gheorghiade M, Kwasny MJ, Fought AJ, Zannad F, et al. Gender does not affect postdischarge outcomes in patients hospitalized for worsening heart failure with reduced ejection fraction (from the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan [EVEREST] Trial). Am J Cardiol. 2012;110:1803–8. doi:10.1016/j.amjcard.2012.08.016.

    Article  PubMed  Google Scholar 

  16. Martínez-Sellés M, Doughty RN, Poppe K, Whalley GA, Earle N, Tribouilloy C, et al. Gender and survival in patients with heart failure: interactions with diabetes and aetiology. Results from the MAGGIC individual patient meta-analysis. Eur J Heart Fail. 2012;14:473–9. doi:10.1093/eurjhf/hfs026.

    Article  PubMed  Google Scholar 

  17. Adams KF, Dunlap SH, Sueta CA, Clarke SW, Patterson JH, Blauwet MB, et al. Relation between gender, etiology and survival in patients with symptomatic heart failure. J Am Coll Cardiol. 1996;28:1781–8. doi:10.1016/S0735-1097(96)00380-4.

    Article  PubMed  Google Scholar 

  18. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368:1005–11. doi:10.1016/S0140-6736(06)69208-8.

    Article  PubMed  Google Scholar 

  19. Grimard BH, Safford RE, Burns EL. Aortic stenosis: diagnosis and treatment. Am Fam Physician. 2016;93:371–8.

    PubMed  Google Scholar 

  20. Iivanainen AM, Lindroos M, Tilvis R, Heikkilä J, Kupari M. Natural history of aortic valve stenosis of varying severity in the elderly. Am J Cardiol. 1996;78:97–101.

    Article  CAS  PubMed  Google Scholar 

  21. Liyanage L, Lee NJ, Cook T, Herrmann HC, Jagasia D, Litt H, et al. The impact of gender on cardiovascular system calcification in very elderly patients with severe aortic stenosis. Int J Cardiovasc Imaging. 2016;32:173–9. doi:10.1007/s10554-015-0752-5.

    Article  PubMed  Google Scholar 

  22. Yarnoz MJ, Curtis AB. More reasons why men and women are not the same (gender differences in electrophysiology and arrhythmias). Am J Cardiol. 2008;101:1291–6. doi:10.1016/j.amjcard.2007.12.027.

    Article  PubMed  Google Scholar 

  23. Pothineni NV, Shirazi LF, Mehta JL. Gender differences in autonomic control of the cardiovascular system. Curr Pharm Des. 2016;22:3829–34.

    Article  CAS  PubMed  Google Scholar 

  24. Koenig J, Thayer JF. Sex differences in healthy human heart rate variability: a meta-analysis. Neurosci Biobehav Rev. 2016;64:288–310. doi:10.1016/j.neubiorev.2016.03.007.

    Article  PubMed  Google Scholar 

  25. Cordero A, Alegria E. Sex differences and cardiovascular risk. Heart. 2006;92:145–6. doi:10.1136/hrt.2005.069187.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atrial fibrillation in adults. JAMA. 2001;285:2370. doi:10.1001/jama.285.18.2370.

    Article  CAS  PubMed  Google Scholar 

  27. Falk RH. Atrial fibrillation. N Engl J Med. 2001;344:1067–78. doi:10.1056/NEJM200104053441407.

    Article  CAS  PubMed  Google Scholar 

  28. Heeringa J, van der Kuip DAM, Hofman A, Kors JA, van Herpen G, Stricker BHC, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27:949–53. doi:10.1093/eurheartj/ehi825.

    Article  PubMed  Google Scholar 

  29. Cabin HS, Clubb KS, Hall C, Perlmutter RA, Feinstein AR. Risk for systemic embolization of atrial fibrillation without mitral stenosis. Am J Cardiol. 1990;65:1112–6.

    Article  CAS  PubMed  Google Scholar 

  30. Rautaharju PM, Zhou SH, Wong S, Calhoun HP, Berenson GS, Prineas R, et al. Sex differences in the evolution of the electrocardiographic QT interval with age. Can J Cardiol. 1992;8:690–5.

    CAS  PubMed  Google Scholar 

  31. Hara M, Danilo P, Rosen MR. Effects of gonadal steroids on ventricular repolarization and on the response to E4031. J Pharmacol Exp Ther. 1998;285:1068–72.

    CAS  PubMed  Google Scholar 

  32. Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH. Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs. JAMA. 1993;270:2590–7.

    Article  CAS  PubMed  Google Scholar 

  33. Reinoehl J, Frankovich D, Machado C, Kawasaki R, Baga JJ, Pires LA, et al. Probucol-associated tachyarrhythmic events and QT prolongation: importance of gender. Am Heart J. 1996;131:1184–91.

    Article  CAS  PubMed  Google Scholar 

  34. Kannel WB, Wilson PW, D’Agostino RB, Cobb J. Sudden coronary death in women. Am Heart J. 1998;136:205–12. doi:10.1053/hj.1998.v136.90226.

    Article  CAS  PubMed  Google Scholar 

  35. Salmon JE, Roman MJ. Subclinical atherosclerosis in rheumatoid arthritis and systemic lupus erythematosus. Am J Med. 2008;121:S3–8. doi:10.1016/j.amjmed.2008.06.010.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Wilson PWF, D’Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med. 2002;162:1867–72.

    Article  PubMed  Google Scholar 

  37. Tankó LB, Christiansen C, Cox DA, Geiger MJ, McNabb MA, Cummings SR. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J Bone Miner Res. 2005;20:1912–20. doi:10.1359/JBMR.050711.

    Article  PubMed  Google Scholar 

  38. Veronese N, Trevisan C, De Rui M, Bolzetta F, Maggi S, Zambon S, et al. Association of osteoarthritis with increased risk of cardiovascular diseases in the elderly: findings from the Progetto Veneto Anziano Study Cohort. Arthritis Rheum. 2016;68:1136–44. doi:10.1002/art.39564.

    CAS  Google Scholar 

  39. Dickerson JA, Nagaraja HN, Raman SV. Gender-related differences in coronary artery dimensions: a volumetric analysis. Clin Cardiol. 2010;33:E44–9. doi:10.1002/clc.20509.

    Article  PubMed  Google Scholar 

  40. Han SH, Bae JH, Holmes DR, Lennon RJ, Eeckhout E, Barsness GW, et al. Sex differences in atheroma burden and endothelial function in patients with early coronary atherosclerosis. Eur Heart J. 2008;29:1359–69. doi:10.1093/eurheartj/ehn142.

    Article  PubMed  Google Scholar 

  41. Reis SE, Holubkov R, Conrad Smith AJ, Kelsey SF, Sharaf BL, Reichek N, et al. Coronary microvascular dysfunction is highly prevalent in women with chest pain in the absence of coronary artery disease: results from the NHLBI WISE study. Am Heart J. 2001;141:735–41.

    Article  CAS  PubMed  Google Scholar 

  42. Sharaf BL, Pepine CJ, Kerensky RA, Reis SE, Reichek N, Rogers WJ, et al. Detailed angiographic analysis of women with suspected ischemic chest pain (pilot phase data from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation [WISE] Study Angiographic Core Laboratory). Am J Cardiol. 2001;87:937–41. A3.

    Article  CAS  PubMed  Google Scholar 

  43. Johnson BD, Shaw LJ, Pepine CJ, Reis SE, Kelsey SF, Sopko G, et al. Persistent chest pain predicts cardiovascular events in women without obstructive coronary artery disease: results from the NIH-NHLBI-sponsored Women’s Ischaemia Syndrome Evaluation (WISE) study. Eur Heart J. 2006;27:1408–15. doi:10.1093/eurheartj/ehl040.

    Article  PubMed  Google Scholar 

  44. Berger JS, Elliott L, Gallup D, Roe M, Granger CB, Armstrong PW, et al. Sex differences in mortality following acute coronary syndromes. JAMA. 2009;302:874–82. doi:10.1001/jama.2009.1227.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Dey S, Flather MD, Devlin G, Brieger D, Gurfinkel EP, Steg PG, et al. Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes: the Global Registry of Acute Coronary Events. Heart. 2009;95:20–6. doi:10.1136/hrt.2007.138537.

    Article  CAS  PubMed  Google Scholar 

  46. Lansky AJ, Ng VG, Maehara A, Weisz G, Lerman A, Mintz GS, et al. Gender and the extent of coronary atherosclerosis, plaque composition, and clinical outcomes in acute coronary syndromes. JACC Cardiovasc Imaging. 2012;5:S62–72. doi:10.1016/j.jcmg.2012.02.003.

    Article  PubMed  Google Scholar 

  47. Dagres N, Nieuwlaat R, Vardas PE, Andresen D, Lévy S, Cobbe S, et al. Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: a report from the Euro Heart Survey on Atrial Fibrillation. J Am Coll Cardiol. 2007;49:572–7. doi:10.1016/j.jacc.2006.10.047.

    Article  PubMed  Google Scholar 

  48. Benjamin EJ, Levy D, Vaziri SM, D’Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994;271:840–4.

    Article  CAS  PubMed  Google Scholar 

  49. Franken RA, Rosa RF, Santos SC. Atrial fibrillation in the elderly. J Geriatr Cardiol. 2012;9:91–100. doi:10.3724/SP.J.1263.2011.12293.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Burke AP, Farb A, Malcom GT, Liang Y, Smialek J, Virmani R. Effect of risk factors on the mechanism of acute thrombosis and sudden coronary death in women. Circulation. 1998;97(21):2110–6.

    Article  CAS  PubMed  Google Scholar 

  51. Meischke H, Larsen MP, Eisenberg MS. Gender differences in reported symptoms for acute myocardial infarction: impact on prehospital delay time interval. Am J Emerg Med. 1998;16:363–6.

    Article  CAS  PubMed  Google Scholar 

  52. • Khamis RY, Ammari T, Mikhail GW. Gender differences in coronary heart disease. Heart. 2016;102:1142–9. doi:10.1136/heartjnl-2014-306463. This article summarizes the current evidence regarding gender-specific variability in coronary heart disease in terms of symptomatology, treatment, and outcomes.

    Article  PubMed  Google Scholar 

  53. Oertelt-Prigione S, Seeland U, Kendel F, Rücke M, Flöel A, Gaissmaier W, et al. Cardiovascular risk factor distribution and subjective risk estimation in urban women—the BEFRI study: a randomized cross-sectional study. BMC Med. 2015;13:52. doi:10.1186/s12916-015-0304-9.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Rosenfeld AG, Lindauer A, Darney BG. Understanding treatment-seeking delay in women with acute myocardial infarction: descriptions of decision-making patterns. Am J Crit Care. 2005;14:285–93.

    PubMed  Google Scholar 

  55. Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373:929–38. doi:10.1056/NEJMoa1406761.

    Article  CAS  PubMed  Google Scholar 

  56. Tsuchihashi K, Ueshima K, Uchida T, Oh-mura N, Kimura K, Owa M, et al. Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarction. J Am Coll Cardiol. 2001;38:11–8. doi:10.1016/S0735-1097(01)01316-X.

    Article  CAS  PubMed  Google Scholar 

  57. Fuchs C, Mascherbauer J, Rosenhek R, Pernicka E, Klaar U, Scholten C, et al. Gender differences in clinical presentation and surgical outcome of aortic stenosis. Heart. 2010;96:539–45. doi:10.1136/hrt.2009.186650.

    Article  PubMed  Google Scholar 

  58. Rohde LE, Zhi G, Aranki SF, Beckel NE, Lee RT, Reimold SC. Gender-associated differences in left ventricular geometry in patients with aortic valve disease and effect of distinct overload subsets. Am J Cardiol. 1997;80:475–80.

    Article  CAS  PubMed  Google Scholar 

  59. Hnatkova K, Waktare JE, Murgatroyd FD, Guo X, Camm AJ, Malik M. Age and gender influences on rate and duration of paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 1998;21:2455–8.

    Article  CAS  PubMed  Google Scholar 

  60. Wigginton JG, Pepe PE, Bedolla JP, DeTamble LA, Atkins JM. Sex-related differences in the presentation and outcome of out-of-hospital cardiopulmonary arrest: a multiyear, prospective, population-based study. Crit Care Med. 2002;30:S131–6.

    Article  PubMed  Google Scholar 

  61. Crilly MA, Bundred PE, Leckey LC, Johnstone FC. Gender bias in the clinical management of women with angina: another look at the Yentl Syndrome. J Women’s Health. 2008;17:331–42. doi:10.1089/jwh.2007.0383.

    Article  Google Scholar 

  62. Hemingway H, Chen R, Junghans C, Timmis A, Eldridge S, Black N, et al. Appropriateness criteria for coronary angiography in angina: reliability and validity. Ann Intern Med. 2008;149:221. doi:10.7326/0003-4819-149-4-200808190-00003.

    Article  PubMed  Google Scholar 

  63. Kwok Y, Kim C, Grady D, Segal M, Redberg R. Meta-analysis of exercise testing to detect coronary artery disease in women. Am J Cardiol. 1999;83:660–6. doi:10.1016/S0002-9149(98)00963-1.

    Article  CAS  PubMed  Google Scholar 

  64. Mieres JH, Gulati M, Bairey Merz N, Berman DS, Gerber TC, Hayes SN, et al. Role of noninvasive testing in the clinical evaluation of women with suspected ischemic heart disease. Circulation. 2014;130:350–79.

    Article  PubMed  Google Scholar 

  65. Johnson BD, Shaw LJ, Buchthal SD, Bairey Merz CN, Kim H-W, Scott KN, et al. Prognosis in women with myocardial ischemia in the absence of obstructive coronary disease: results from the National Institutes of Health-National Heart, Lung, and Blood Institute-Sponsored Women’s Ischemia Syndrome Evaluation (WISE). Circulation. 2004;109:2993–9. doi:10.1161/01.CIR.0000130642.79868.B2.

    Article  PubMed  Google Scholar 

  66. Worrall-Carter L, MacIsaac A, Scruth E, Rahman MA. Gender difference in the use of coronary interventions for patients with acute coronary syndrome: experience from a major metropolitan hospital in Melbourne, Australia. Aust Crit Care. 2016. doi:10.1016/j.aucc.2016.03.005.

    PubMed  Google Scholar 

  67. Haimi I, Lee HJ, Mehta S, Salwan R, Zambahari R, Chen Y, et al. CRT-200.92 gender disparities in ST-elevation myocardial infarction care and outcomes in emerging countries: a Global Lumen Organization for Women (GLOW) initiative and call to action. JACC Cardiovasc Interv. 2016;9:S31. doi:10.1016/j.jcin.2015.12.124.

    Article  Google Scholar 

  68. Raphael CE, Spoon D, Lennon R, Crusan D, Singh M, Lerman A, et al. Gender differences in cause of death following percutaneous coronary intervention. J Am Coll Cardiol. 2016;67:329. doi:10.1016/S0735-1097(16)30330-8.

    Article  Google Scholar 

  69. O’Donoghue M, Boden WE, Braunwald E, Cannon CP, Clayton TC, de Winter RJ, et al. Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis. JAMA. 2008;300:71–80. doi:10.1001/jama.300.1.71.

    Article  PubMed  Google Scholar 

  70. Blomkalns AL, Chen AY, Hochman JS, Peterson ED, Trynosky K, Diercks DB, et al. Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. J Am Coll Cardiol. 2005;45:832–7. doi:10.1016/j.jacc.2004.11.055.

    Article  PubMed  Google Scholar 

  71. Roe YL, Zeitz CJ, Mittinty MN, McDermott RA, Chew DP. Impact of age, gender and indigenous status on access to diagnostic coronary angiography for patients presenting with non-ST segment elevation acute coronary syndromes in Australia. Intern Med J. 2013;43:317–22. doi:10.1111/imj.12050.

    Article  CAS  PubMed  Google Scholar 

  72. Assiri AS. Gender differences in clinical presentation and management of patients with acute coronary syndrome in southwest of Saudi Arabia. J Saudi Hearth Assoc. 2011;23:135–41. doi:10.1016/j.jsha.2011.01.007.

    Article  Google Scholar 

  73. Levin RI. The puzzle of aspirin and sex. N Engl J Med. 2005;352:1366–8. doi:10.1056/NEJMe058051.

    Article  CAS  PubMed  Google Scholar 

  74. Price MJ, Nayak KR, Barker CM, Kandzari DE, Teirstein PS. Predictors of heightened platelet reactivity despite dual-antiplatelet therapy in patients undergoing percutaneous coronary intervention. Am J Cardiol. 2009;103:1339–43. doi:10.1016/j.amjcard.2009.01.341.

    Article  CAS  PubMed  Google Scholar 

  75. Mora S, Glynn RJ, Hsia J, MacFadyen JG, Genest J, Ridker PM. Statins for the primary prevention of cardiovascular events in women with elevated high-sensitivity C-reactive protein or dyslipidemia. Circulation. 2010;121:1069–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Puri R, Nicholls SJ, Shao M, Kataoka Y, Uno K, Kapadia SR, et al. Impact of statins on serial coronary calcification during atheroma progression and regression. J Am Coll Cardiol. 2015;65:1273–82. doi:10.1016/j.jacc.2015.01.036.

    Article  CAS  PubMed  Google Scholar 

  77. Ballo P, Balzi D, Barchielli A, Turco L, Franconi F, Zuppiroli A. Gender differences in statin prescription rates, adequacy of dosing, and association of statin therapy with outcome after heart failure hospitalization: a retrospective analysis in a community setting. Eur J Clin Pharmacol. 2016;72:311–9. doi:10.1007/s00228-015-1980-2.

    Article  CAS  PubMed  Google Scholar 

  78. Hartzell M, Malhotra R, Yared K, Rosenfield HR, Walker JD, Wood MJ. Effect of gender on treatment and outcomes in severe aortic stenosis. Am J Cardiol. 2011;107:1681–6. doi:10.1016/j.amjcard.2011.01.059.

    Article  PubMed  Google Scholar 

  79. Forrest JK, Adams DH, Popma JJ, Reardon MJ, Deeb GM, Yakubov SJ, et al. Transcatheter aortic valve replacement in women versus men (from the US CoreValve Trials). Am J Cardiol. 2016;118:396–402. doi:10.1016/j.amjcard.2016.05.013.

    Article  PubMed  Google Scholar 

  80. Hayashida K, Morice M-C, Chevalier B, Hovasse T, Romano M, Garot P, et al. Sex-related differences in clinical presentation and outcome of transcatheter aortic valve implantation for severe aortic stenosis. J Am Coll Cardiol. 2012;59:566–71. doi:10.1016/j.jacc.2011.10.877.

    Article  PubMed  Google Scholar 

  81. Forleo GB, Tondo C, De Luca L, Dello Russo A, Casella M, De Sanctis V, et al. Gender-related differences in catheter ablation of atrial fibrillation. Europace. 2007;9:613–20. doi:10.1093/europace/eum144.

    Article  PubMed  Google Scholar 

  82. Zareba W, Moss AJ, Jackson Hall W, Wilber DJ, Ruskin JN, McNitt S, et al. Clinical course and implantable cardioverter defibrillator therapy in postinfarction women with severe left ventricular dysfunction. J Cardiovasc Electrophysiol. 2005;16:1265–70. doi:10.1111/j.1540-8167.2005.00224.x.

    Article  PubMed  Google Scholar 

  83. Schweikert B, Hunger M, Meisinger C, König H-H, Gapp O, Holle R. Quality of life several years after myocardial infarction: comparing the MONICA/KORA registry to the general population. Eur Heart J. 2009;30:436–43. doi:10.1093/eurheartj/ehn509.

    Article  PubMed  Google Scholar 

  84. Feola M, Garnero S, Daniele B, Mento C, Dell’Aira F, Chizzolini G, et al. Gender differences in the efficacy of cardiovascular rehabilitation in patients after cardiac surgery procedures. J Geriatr Cardiol. 2015;12:575–9. doi:10.11909/j.issn.1671-5411.2015.05.015.

    PubMed  PubMed Central  Google Scholar 

  85. Barth J, Volz A, Schmid J-P, Kohls S, von Kanel R, Znoj H, et al. Gender differences in cardiac rehabilitation outcomes: do women benefit equally in psychological health? J Womens Health (Larchmt). 2009;18:2033–9. doi:10.1089/jwh.2008.1058.

    Article  Google Scholar 

  86. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56.

    Article  CAS  PubMed  Google Scholar 

  87. Newman AB, Gottdiener JS, Mcburnie MA, Hirsch CH, Kop WJ, Tracy R, et al. Associations of subclinical cardiovascular disease with frailty. J Gerontol A Biol Sci Med Sci. 2001;56:M158–66.

    Article  CAS  PubMed  Google Scholar 

  88. Phan HM, Alpert JS, Fain M. Frailty, inflammation, and cardiovascular disease: evidence of a connection. Am J Geriatr Cardiol. 2008;17(2):101–7.

    PubMed  Google Scholar 

  89. Sergi G, Veronese N, Fontana L, De Rui M, Bolzetta F, Zambon S, et al. Pre-frailty and risk of cardiovascular disease in elderly men and women: the Pro.V.A. study. J Am Coll Cardiol. 2015;65:976–83. doi:10.1016/j.jacc.2014.12.040.

    Article  PubMed  Google Scholar 

  90. von Haehling S, Anker SD, Doehner W, Morley JE, Vellas B. Frailty and heart disease. Int J Cardiol. 2013;168:1745–7. doi:10.1016/j.ijcard.2013.07.068.

    Article  Google Scholar 

  91. Afilalo J, Karunananthan S, Eisenberg MJ, Alexander KP, Bergman H. Role of frailty in patients with cardiovascular disease. Am J Cardiol. 2009;103:1616–21. doi:10.1016/j.amjcard.2009.01.375.

    Article  PubMed  Google Scholar 

  92. Afilalo J. Frailty in patients with cardiovascular disease: why, when, and how to measure. Curr Cardiovasc Risk Rep. 2011;5:467–72. doi:10.1007/s12170-011-0186-0.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Newman AB, Fitzpatrick AL, Lopez O, Jackson S, Lyketsos C, Jagust W, et al. Dementia and Alzheimer’s disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort. J Am Geriatr Soc. 2005;53:1101–7. doi:10.1111/j.1532-5415.2005.53360.x.

    Article  PubMed  Google Scholar 

  94. Aronson MK, Ooi WL, Morgenstern H, Hafner A, Masur D, Crystal H, et al. Women, myocardial infarction, and dementia in the very old. Neurology. 1990;40:1102–6. doi:10.1212/WNL.40.7.1102.

    Article  CAS  PubMed  Google Scholar 

  95. Mallik S, Spertus JA, Reid KJ, Krumholz HM, Rumsfeld JS, Weintraub WS, et al. Depressive symptoms after acute myocardial infarction: evidence for highest rates in younger women. Arch Intern Med. 2006;166:876–83. doi:10.1001/archinte.166.8.876.

    Article  PubMed  Google Scholar 

  96. Naqvi TZ, Naqvi SSA, Merz CNB. Gender differences in the link between depression and cardiovascular disease. Psychosom Med. 2005;67 Suppl 1:S15–8. doi:10.1097/01.psy.0000164013.55453.05.

    Article  PubMed  Google Scholar 

  97. • Zaninotto P, Sacker A, Breeze E, McMunn A, Steptoe A. Gender-specific changes in well-being in older people with coronary heart disease: evidence from the English Longitudinal Study of Ageing. Aging Ment Health. 2016;20:432–40. doi:10.1080/13607863.2015.1020410. This recent study investigates the sex-specific differences in quality of life and depressive mood in elderly subjects suffering from coronary heart disease.

    Article  PubMed  Google Scholar 

  98. Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J. 2006;27:2763–74. doi:10.1093/eurheartj/ehl338.

    Article  PubMed  Google Scholar 

  99. Gijsberts CM, Agostoni P, Hoefer IE, Asselbergs FW, Pasterkamp G, Nathoe H, et al. Gender differences in health-related quality of life in patients undergoing coronary angiography. Open Heart. 2015;2:e000231. doi:10.1136/openhrt-2014-000231.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Norris CM, Ghali WA, Galbraith PD, Graham MM, Jensen LA, Knudtson ML, et al. Women with coronary artery disease report worse health-related quality of life outcomes compared to men. Health Qual Life Outcomes. 2004;2:21. doi:10.1186/1477-7525-2-21.

    Article  PubMed  PubMed Central  Google Scholar 

  101. van Jaarsveld CHM, Sanderman R, Ranchor AV, Ormel J, van Veldhuisen DJ, Kempen GIJM. Gender-specific changes in quality of life following cardiovascular disease: a prospective study. J Clin Epidemiol. 2002;55:1105–12.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Via Giustiniani 2, 35128, Padova, Italy

    Caterina Trevisan, Enzo Manzato, Giuseppe Sergi & Nicola Veronese

  2. National Research Council, Institute of Neuroscience, Aging Branch, Padova, Italy

    Stefania Maggi & Enzo Manzato

Authors
  1. Caterina Trevisan
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  2. Stefania Maggi
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  3. Enzo Manzato
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  4. Giuseppe Sergi
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  5. Nicola Veronese
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Correspondence to Caterina Trevisan.

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Drs Trevisan, Maggi, Manzato, Sergi, and Veronese have no conflicts of interests.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Women and Heart Disease

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Trevisan, C., Maggi, S., Manzato, E. et al. Geriatric Insights on Elderly Women and Heart Disease. Curr Cardiovasc Risk Rep 11, 8 (2017). https://doi.org/10.1007/s12170-017-0532-y

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