Vascular Biology and Hypertension

In Western societies, heart disease is the leading cause of death for both men and women, but the incidence and rate of progression of hypertension and associated cardiovascular and renal diseases is significantly greater in men than in age-matched women. While the warning signs of heart attack and cardiovascular disease are well known for men, women may not recognize the symptoms in themselves since the warning signs are frequently different in women.

Indeed, one of the most dramatic manifestations of sex differences is the recent finding that men and women experience very different symptoms before having a heart attack. While any emergency technician is taught that shooting pain up the arm and chest pains are the major symptoms of an impending heart attack, these symptoms rarely occur in women. Instead, as many as 71% of women who have heart attacks report uncharacteristic, unusual fatigue in the month preceding their heart attack, followed by 48% reporting sleep disturbance and 42% reporting shortness of breath. Only 30% of women who have heart attacks report chest pains prior to the attack. With heart disease the number one killer of women, illuminating such differences in symptoms has the potential to save hundreds of thousands of lives each year.

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